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Marnat G, Bühlmann M, Eker OF, Gralla J, Machi P, Fischer U, Riquelme C, Arnold M, Bonafé A, Jung S, Costalat V, Mordasini P. Multicentric Experience in Distal-to-Proximal Revascularization of Tandem Occlusion Stroke Related to Internal Carotid Artery Dissection. AJNR Am J Neuroradiol 2018; 39:1093-1099. [PMID: 29700047 DOI: 10.3174/ajnr.a5640] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 02/07/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Internal carotid dissection is a frequent cause of ischemic stroke in young adults. It may cause tandem occlusions in which cervical carotid obstruction is associated with intracranial proximal vessel occlusion. To date, no consensus has emerged concerning endovascular treatment strategy. Our aim was to evaluate our endovascular "distal-to-proximal" strategy in the treatment of this stroke subtype in the first large multicentric cohort. MATERIALS AND METHODS Prospectively managed stroke data bases from 2 separate centers were retrospectively studied between 2009 and 2014 for records of tandem occlusions related to internal carotid dissection. Atheromatous tandem occlusions were excluded. The first step in the revascularization procedure was intracranial thrombectomy. Then, cervical carotid stent placement was performed depending on the functionality of the circle of Willis and the persistence of residual cervical ICA occlusion, severe stenosis, or thrombus apposition. Efficiency, complications, and radiologic and clinical outcomes were recorded. RESULTS Thirty-four patients presenting with tandem occlusion stroke secondary to internal carotid dissection were treated during the study period. The mean age was 52.5 years, the mean initial NIHSS score was 17.29 ± 6.23, and the mean delay between onset and groin puncture was 3.58 ± 1.1 hours. Recanalization TICI 2b/3 was obtained in 21 cases (62%). Fifteen patients underwent cervical carotid stent placement. There was no recurrence of ipsilateral stroke in the nonstented subgroup. Twenty-one patients (67.65%) had a favorable clinical outcome after 3 months. CONCLUSIONS Endovascular treatment of internal carotid dissection-related tandem occlusion stroke using the distal-to-proximal recanalization strategy appears to be feasible, with low complication rates and considerable rates of successful recanalization.
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Bosch A, Ott C, Kannenkeril D, Harazny J, Striepe K, Karg M, Dienemann T, Jung S, Schmieder R. DIFFERENT RESPONSE PATTERN TO AIRCRAFT NOISE EXPOSURE IN RENAL VERSUS SYSTEMIC HEMODYNAMIC. J Hypertens 2018. [DOI: 10.1097/01.hjh.0000539361.77904.f3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Martin M, Knapp A, Vallat L, Schleiss C, Ghergus D, Korganow A, Gros F, Jung S, Soulas-Sprauel P, Martin T. Expression de ZAP-70 par les lymphocytes B non tumoraux : une nouveau mécanisme de rupture de tolérance B ? Résultats préliminaires in vivo. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Cho I, Kang H, Jo J, Lee H, Chung M, Park J, Park S, Song S, Park M, An C, Jung S, Bang S. FOLFIRINOX versus gemcitabine plus nab-paclitaxel for treatment of metastatic pancreatic cancer: a single-center cohort study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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80
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Lee H, Jung S, Thompson J, Qureshi A, Cho E. 319 Racial characteristics of alopecia areata in the US from the National Alopecia Areata Registry. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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81
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Park I, Jung S, Seo Y, Oh S, Lee K, Kim S, Lee Y, Kim S. 0982 Differential Role of Sleep Disturbance and Stress Level on Depressive Symptoms and Anxiety. Sleep 2018. [DOI: 10.1093/sleep/zsy061.981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lee B, Kim H, Jeong S, Jung S, Shin E, Park H, Lim D, Lee J, Chung J, Yoon M, Han Y. EP-1775: The feasibility study of clinical high accuracy QA system for treatment planning using Monte Carlo. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32084-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Kellner-Weldon F, El-Koussy M, Jung S, Jossen M, Klinger-Gratz PP, Wiest R. Cerebellar Hypoperfusion in Migraine Attack: Incidence and Significance. AJNR Am J Neuroradiol 2018; 39:435-440. [PMID: 29326138 DOI: 10.3174/ajnr.a5508] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 11/05/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Patients diagnosed with migraine with aura have an increased lifetime risk of ischemic stroke. It is not yet clear whether prolonged cortical hypoperfusion during an aura increases the immediate risk of cerebellar infarction because it may induce crossed cerebellar diaschisis and subsequent tissue damage. To address this question, we retrospectively analyzed potential relationships between cortical oligemia and cerebellar hypoperfusion in patients with migraine with aura and their potential relation to small infarct-like cerebellar lesions. MATERIALS AND METHODS One hundred six migraineurs who underwent MR imaging, including DSC perfusion, were included in the study. In patients with apparent perfusion asymmetry, we used ROI analysis encompassing 18 infra- and supratentorial ROIs to account for differences in regional cerebral blood flow and volume. The presence of cerebellar hypoperfusion was calculated using an asymmetry index, with values of >10% being considered significant. RESULTS We observed perfusion asymmetries in 23/106 patients, 22 in patients with migraine with aura (20.8%). Cerebellar hypoperfusion was observed in 12/23 patients (52.2%), and crossed cerebellar diaschisis, in 9/23 patients (39.1%) with abnormal perfusion. In none of the 106 patients were DWI restrictions observed during migraine with aura. CONCLUSIONS Cerebellar hypoperfusion and crossed cerebellar diaschisis are common in patients with migraine with aura and cortical perfusion abnormalities. Crossed cerebellar diaschisis in migraine with aura may be considered a benign phenomenon because we observed no association with DWI restriction or manifest cerebellar infarctions, even in patients with prolonged symptom-related perfusion abnormalities persisting for up to 24 hours.
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Langenmayer MC, Jung S, Majzoub-Altweck M, Trefz FM, Seifert C, Knubben-Schweizer G, Fries R, Hermanns W, Gollnick NS. Zinc Deficiency-Like Syndrome in Fleckvieh Calves: Clinical and Pathological Findings and Differentiation from Bovine Hereditary Zinc Deficiency. J Vet Intern Med 2018; 32:853-859. [PMID: 29424482 PMCID: PMC5866964 DOI: 10.1111/jvim.15040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 11/17/2017] [Accepted: 12/14/2017] [Indexed: 12/17/2022] Open
Abstract
Background Zinc deficiency‐like (ZDL) syndrome is an inherited defect of Fleckvieh calves, with striking similarity to bovine hereditary zinc deficiency (BHZD). However, the causative mutation in a phospholipase D4 encoding gene (PLD4) shows no connection to zinc metabolism. Objectives To describe clinical signs, laboratory variables, and pathological findings of ZDL syndrome and their utility to differentiate ZDL from BHZD and infectious diseases with similar phenotype. Animals Nine hospitalized calves with crusting dermatitis and confirmed mutation in PLD4 and medical records from 25 calves with crusting dermatitis or suspected zinc deficiency. Methods Prospective and retrospective case series. Results The 9 calves (age: 5–53 weeks) displayed a moderate to severe crusting dermatitis mainly on the head, ventrum, and joints. Respiratory and digestive tract inflammations were frequently observed. Zinc supplementation did not lead to remission of clinical signs in 4 calves. Laboratory variables revealed slight anemia in 8 calves, hypoalbuminemia in 6 calves, but reduced serum zinc concentrations in only 3 calves. Mucosal erosions/ulcerations were present in 7 calves and thymus atrophy or reduced thymic weights in 8 calves. Histologically, skin lesions were indistinguishable from BHZD. Retrospective analysis of medical records revealed the presence of this phenotype since 1988 and pedigree analysis revealed a common ancestor of several affected calves. Conclusions and Clinical Importance ZDL syndrome should be suspected in Fleckvieh calves with crusting dermatitis together with diarrhea or respiratory tract inflammations without response to oral zinc supplementation. Definite diagnosis requires molecular genetic confirmation of the PLD4 mutation.
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Leigh J, Jung S, Kim Y, Park S, Seo H, Yeom H, Chung C, Kim S, Bang M. Development of brain-machine interface for integrated robot Arm-gripper system control using non-invasive and less-invasive technology. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Jung S, Leigh J, Seo H, Oh B, Bang M. Acceptance and usability of the brain–machine interface: Focus group findings. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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87
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Jung S, Kim MK, Choi BY. The long-term relationship between dietary pantothenic acid (vitamin B 5) intake and C-reactive protein concentration in adults aged 40 years and older. Nutr Metab Cardiovasc Dis 2017; 27:806-816. [PMID: 28739188 DOI: 10.1016/j.numecd.2017.05.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 04/28/2017] [Accepted: 05/24/2017] [Indexed: 01/20/2023]
Abstract
BACKGROUND AND AIMS Low-grade inflammation, represented by minor C-reactive protein (CRP) elevation, has a critical role in the early stages of atherosclerosis, and pantothenic acid (PA) may have an antioxidant effect in inflammatory process. However, the long-term relationship between PA intake and CRP has not yet been studied. The objective of the present study was to evaluate the long-term relationship of PA intake to CRP concentration in healthy adults aged 40 years or older living in a rural area of South Korea. METHODS AND RESULTS A total of 908 subjects (349 men, 559 women) with repeated data on dietary PA intake and CRP concentration were included in the final analysis. To represent the long-term effect of PA intake, both PA intake at the baseline and average PA intake were used as the exposure, and CRP concentration at the third visit and its change from the baseline to the third visit were used as the outcome. After adjustment for potential confounders, a significant inverse relationship between PA intake and CRP concentration at the third visit was observed (P for trend = 0.001, β = -0.07 (P-value = 0.001) for PA baseline; P for trend = <0.0001, β = -0.11 (P-value = 0.0004) for PA average (baseline, 2nd, 3rd)). Higher PA intake was significantly related to lower or attenuated increase in CRP concentration (P for trend = 0.002, β = -0.24 (P-value = 0.002) for PA baseline; P for trend = 0.001, β = -0.35 (P-value = 0.001) for PA average (baseline, 2nd, 3rd)). CONCLUSIONS In conclusion, dietary PA intake was inversely related to subsequent CRP concentration in both men and women aged 40 years or older in South Korea.
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You S, Jung S, Park S, Park R. 3893Comparison between first line dual-combination therapies in hypertension: nationwide population based cohort study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.3893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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89
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McKinley R, Häni L, Gralla J, El-Koussy M, Bauer S, Arnold M, Fischer U, Jung S, Mattmann K, Reyes M, Wiest R. Fully automated stroke tissue estimation using random forest classifiers (FASTER). J Cereb Blood Flow Metab 2017; 37:2728-2741. [PMID: 27798267 PMCID: PMC5536784 DOI: 10.1177/0271678x16674221] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Several clinical trials have recently proven the efficacy of mechanical thrombectomy for treating ischemic stroke, within a six-hour window for therapy. To move beyond treatment windows and toward personalized risk assessment, it is essential to accurately identify the extent of tissue-at-risk ("penumbra"). We introduce a fully automated method to estimate the penumbra volume using multimodal MRI (diffusion-weighted imaging, a T2w- and T1w contrast-enhanced sequence, and dynamic susceptibility contrast perfusion MRI). The method estimates tissue-at-risk by predicting tissue damage in the case of both persistent occlusion and of complete recanalization. When applied to 19 test cases with a thrombolysis in cerebral infarction grading of 1-2a, mean overestimation of final lesion volume was 30 ml, compared with 121 ml for manually corrected thresholding. Predicted tissue-at-risk volume was positively correlated with final lesion volume ( p < 0.05). We conclude that prediction of tissue damage in the event of either persistent occlusion or immediate and complete recanalization, from spatial features derived from MRI, provides a substantial improvement beyond predefined thresholds. It may serve as an alternative method for identifying tissue-at-risk that may aid in treatment selection in ischemic stroke.
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Christenson M, Stemmley S, Jung S, Mettler J, Sang X, Martin D, Kalathiparambil K, Ruzic DN. Determining the ion temperature and energy distribution in a lithium-plasma interaction test stand with a retarding field energy analyzer. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2017; 88:083501. [PMID: 28863682 DOI: 10.1063/1.4995601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The ThermoElectric-driven Liquid-metal plasma-facing Structures (TELS) experiment at the University of Illinois is a gas-puff driven, theta-pinch plasma source that is used as a test stand for off-normal plasma events incident on materials in the edge and divertor regions of a tokamak. The ion temperatures and resulting energy distributions are crucial for understanding how well a TELS pulse can simulate an extreme event in a larger, magnetic confinement device. A retarding field energy analyzer (RFEA) has been constructed for use with such a transient plasma due to its inexpensive and robust nature. The innovation surrounding the use of a control analyzer in conjunction with an actively sampling analyzer is presented and the conditions of RFEA operation are discussed, with results presented demonstrating successful performance under extreme conditions. Such extreme conditions are defined by heat fluxes on the order of 0.8 GW m-2 and on time scales of nearly 200 μs. Measurements from the RFEA indicate two primary features for a typical TELS discharge, following closely with the pre-ionizing coaxial gun discharge characteristics. For the case using the pre-ionization pulse (PiP) and the theta pinch, the measured ion signal showed an ion temperature of 23.3 ± 6.6 eV for the first peak and 17.6 ± 1.9 eV for the second peak. For the case using only the PiP, the measured signal showed an ion temperature of 7.9 ± 1.1 eV for the first peak and 6.6 ± 0.8 eV for the second peak. These differences illustrate the effectiveness of the theta pinch for imparting energy on the ions. This information also highlights the importance of TELS as being one of the few linear pulsed plasma sources whereby moderately energetic ions will strike targets without the need for sample biasing.
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Jung S, Sehouli J, Chekerov R, Kluschke F, Patzelt A, Fuss H, Knorr F, Lademann J. Prevention of palmoplantar erythrodysesthesia in patients treated with pegylated liposomal doxorubicin (Caelyx®). Support Care Cancer 2017; 25:3545-3549. [PMID: 28653108 DOI: 10.1007/s00520-017-3781-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 06/07/2017] [Indexed: 12/30/2022]
Abstract
PURPOSE Palmoplantar erythrodysesthesia (PPE) is one of the most frequent side effects during systemic treatment with pegylated liposomal doxorubicin (PLD, Caelyx®). PPE lesions show a range of symptoms, from numbness to painful erosions, and can have a major impact on the quality of life in affected patients. Previously, a possible pathomechanism of PPE was found in doxorubicin-treated patients based on radical formation in the skin. Here, a preventive strategy using a topically applied ointment with a high radical protection factor was investigated. METHODS In this randomized placebo-controlled double-blind study the antioxidant-containing ointment was compared with a placebo ointment regarding PPE grade III occurrence, overall PPE grade I-III occurrence and PPE severity in PLD patients. The verum or placebo cream was topically applied for a period of 16 weeks, starting 3 days prior to the first cycle of chemotherapy. Clinical evaluations were carried out by a dermatologist prior to the first cycle of chemotherapy and every 4 weeks for the duration of 16 weeks. RESULTS Thirty-two patients were enrolled in total, of which 17 (66%) completed the study. No PPE grade III was found in the verum group, while five out of seven patients (71%) had to be unblinded in the placebo arm due to PPE grade III (p = 0.003). General PPE occurrence of all grades was 60% under verum and 86% under placebo treatment. CONCLUSIONS The preventive application of an antioxidant-containing ointment was shown to be significantly more effective in the prevention of PPE grade III compared to placebo treatment.
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Mueller L, Pult F, Meisterernst J, Heldner MR, Mono ML, Kurmann R, Buehlmann M, Fischer U, Mattle HP, Arnold M, Mordasini P, Gralla J, Schroth G, El-Koussy M, Jung S. Impact of intravenous thrombolysis on recanalization rates in patients with stroke treated with bridging therapy. Eur J Neurol 2017. [DOI: 10.1111/ene.13330] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hanisch M, Baumhoer D, Elges S, Fröhlich LF, Kleinheinz J, Jung S. Sclerosing odontogenic carcinoma: current diagnostic and management considerations concerning a most unusual neoplasm. Int J Oral Maxillofac Surg 2017. [PMID: 28641898 DOI: 10.1016/j.ijom.2017.05.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Sclerosing odontogenic carcinoma (SOC) is a primary intraosseous carcinoma of the jaws that has been listed as a separate entity for the first time in the latest version of the World Health Organization classification of Head and Neck Tumours (2017). The aim of this study was to analyse and interpret the existing literature on SOC in the context of a clinical case treated in the authors' department. A systematic search of the PubMed database was performed in accordance with the PRISMA guidelines, yielding nine cases of SOC reported so far. In summary, characteristic clinical and radiological features of SOC include asymptomatic swelling, location predominantly in the mandible, tumour primarily lytic in appearance, presence of cortical bone destruction, and lack of metastatic spread. Due to the rarity of the disease, close collaboration between oral/maxillofacial surgeons and pathologists is crucial to avoid misdiagnosis. With complete excision, no recurrence of SOC should be expected.
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Scott D, Pitcher B, Liu Y, Boyle M, Mottok A, Said J, Chadburn A, Lai R, Jung S, Bartlett N, Leonard J, Kaplan L, Hsi E. HIGH PROLIFERATION (MCL35 ASSAY) IS ASSOCIATED WITH INFERIOR OUTCOMES IN PATIENTS TREATED WITH INTENSIVE REGIMENS-A CORRELATIVE STUDY FROM THE CALGB 50403 (ALLIANCE) TRIAL. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Thanarajasingam G, Dueck A, Novotny P, Witzig T, Habermann T, Nowakowski G, Flowers C, Bartlett N, Blum K, Pitcher B, Jung S, Atherton P, Tan A, Sloan J, Leonard J. BEYOND MAXIMUM GRADE: A NOVEL, LONGITUDINAL TOXICITY OVER TIME (TOXT) ADVERSE EVENT ANALYSIS OF LENALIDOMIDE IN FOLLICULAR LYMPHOMA IN CALGB 50401 (ALLIANCE). Hematol Oncol 2017. [DOI: 10.1002/hon.2438_78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Martin P, Jung S, Pitcher B, Bartlett N, Blum K, Shea T, Ruan J, Smith S, Leonard J, Cheson B. FINAL RESULTS OF CALGB 50803 (ALLIANCE): A PHASE 2 TRIAL OF LENALIDOMIDE PLUS RITUXIMAB IN PATIENTS WITH PREVIOUSLY UNTREATED FOLLICULAR LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Slezak A, Kurmann R, Oppliger L, Broeg-Morvay A, Gralla J, Schroth G, Mattle HP, Arnold M, Fischer U, Jung S, Greif R, Neff F, Mordasini P, Mono ML. Impact of Anesthesia on the Outcome of Acute Ischemic Stroke after Endovascular Treatment with the Solitaire Stent Retriever. AJNR Am J Neuroradiol 2017; 38:1362-1367. [PMID: 28473340 DOI: 10.3174/ajnr.a5183] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 02/14/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE General anesthesia during endovascular treatment of acute ischemic stroke may have an adverse effect on outcome compared with conscious sedation. The aim of this study was to examine the impact of the type of anesthesia on the outcome of patients with acute ischemic stroke treated with the Solitaire stent retriever, accounting for confounding factors. MATERIALS AND METHODS Four-hundred one patients with consecutive acute anterior circulation stroke treated with a Solitaire stent retriever were included in this prospective analysis. Outcome was assessed after 3 months by the modified Rankin Scale. RESULTS One-hundred thirty-five patients (31%) underwent endovascular treatment with conscious sedation, and 266 patients (69%), with general anesthesia. Patients under general anesthesia had higher NIHSS scores on admission (17 versus 13, P < .001) and more internal carotid artery occlusions (44.6% versus 14.8%, P < .001) than patients under conscious sedation. Other baseline characteristics such as time from symptom onset to the start of endovascular treatment did not differ. Favorable outcome (mRS 0-2) was more frequent with conscious sedation (47.4% versus 32%; OR, 0.773; 95% CI, 0.646-0.925; P = .002) in univariable but not multivariable logistic regression analysis (P = .629). Mortality did not differ (P = .077). Independent predictors of outcome were age (OR, 0.95; 95% CI, 0.933-0.969; P < .001), NIHSS score (OR, 0.894; 95% CI, 0.855-0.933; P < .001), time from symptom onset to the start of endovascular treatment (OR, 0.998; 95% CI, 0.996-0.999; P = .011), diabetes mellitus (OR, 0.544; 95% CI, 0.305-0.927; P = .04), and symptomatic intracerebral hemorrhage (OR, 0.109; 95% CI, 0.028-0.428; P = .002). CONCLUSIONS In this single-center study, the anesthetic management during stent retriever thrombectomy with general anesthesia or conscious sedation had no impact on the outcome of patients with large-vessel occlusion in the anterior circulation.
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Jung S, Lademann J, Darvin M, Richter C, Pedersen C, Richter H, Schanzer S, Kottner J, Blume-Peytavi U, Røpke M. 272 Structural changes in human skin after topical application of glucocorticoids assessed by in vivo imaging technologies. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Park S, Choi Y, Kwak G, Hong Y, Jung N, Kim J, Choi B, Jung S. Restoration of neuromuscular function in charcot-marie-tooth (CMT)1a disease by human tonsil-derived MSC (T-MSC). Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lee M, Jung S, Choi J, Lee J, Shin A, Lee Y. 0344 TRENDS IN PRESCRIPTIONS OF SEDATIVE-HYPNOTICS AMONG KOREAN ADULTS: A NATIONWIDE PRESCRIPTION DATABASE STUDY 2011–2015. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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