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Chen M, Kronsteiner D, Pfaff J, Schieber S, Jäger L, Bendszus M, Kieser M, Möhlenbruch MA, Ringleb PA, Bösel J, Schönenberger S. Hemodynamic Status During Endovascular Stroke Treatment: Association of Blood Pressure with Functional Outcome. Neurocrit Care 2021; 35:825-834. [PMID: 34142339 PMCID: PMC8692300 DOI: 10.1007/s12028-021-01229-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/06/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Optimal blood pressure (BP) management during endovascular stroke treatment in patients with large-vessel occlusion is not well established. We aimed to investigate associations of BP during different phases of endovascular therapy with reperfusion and functional outcome. METHODS We performed a post hoc analysis of a single-center prospective study that evaluated a new simplified procedural sedation standard during endovascular therapy (Keep Evaluating Protocol Simplification in Managing Periinterventional Light Sedation for Endovascular Stroke Treatment). BP during endovascular therapy in patients was managed according to protocol. Data from four different phases (baseline, pre-recanalization, post recanalization, and post intervention) were obtained, and mean BP values, as well as changes in BP between different phases and reductions in systolic BP (SBP) and mean arterial pressure (MAP) from baseline to pre-recanalization, were used as exposure variables. The main outcome was a modified Rankin Scale score of 0-2 three months after admission. Secondary outcomes were successful reperfusion and change in the National Institutes of Health Stroke Scale score after 24 h. Multivariable linear and logistic regression models were used for statistical analysis. RESULTS Functional outcomes were analyzed in 139 patients with successful reperfusion (defined as thrombolysis in cerebral infarction grade 2b-3). The mean (standard deviation) age was 76 (10.9) years, the mean (standard deviation) National Institutes of Health Stroke Scale score was 14.3 (7.5), and 70 (43.5%) patients had a left-sided vessel occlusion. Favorable functional outcome (modified Rankin Scale score 0-2) was less likely with every 10-mm Hg increase in baseline (odds ratio [OR] 0.76, P = 0.04) and pre-recanalization (OR 0.65, P = 0.011) SBP. This was also found for baseline (OR 0.76, P = 0.05) and pre-recanalization MAP (OR 0.66, P = 0.03). The maximum Youden index in a receiver operating characteristics analysis revealed an SBP of 163 mm Hg and MAP of 117 mm Hg as discriminatory thresholds during the pre-recanalization phase to predict functional outcome. CONCLUSIONS In our protocol-based setting, intraprocedural pre-recanalization BP reductions during endovascular therapy were not associated with functional outcome. However, higher intraprocedural pre-recanalization SBP and MAP were associated with worse functional outcome. Prospective randomized controlled studies are needed to determine whether BP is a feasible treatment target for the modification of outcomes.
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Affiliation(s)
- Min Chen
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany.
| | - Dorothea Kronsteiner
- Institute of Medical Biometry and Informatics, Heidelberg University, Heidelberg, Germany
| | - Johannes Pfaff
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Simon Schieber
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Laura Jäger
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Meinhard Kieser
- Institute of Medical Biometry and Informatics, Heidelberg University, Heidelberg, Germany
| | - Markus A Möhlenbruch
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Peter A Ringleb
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Julian Bösel
- Department of Neurology, Kassel General Hospital, Kassel, Germany
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Avci-Adali M, Weber M, Fech A, Jäger L, Martirosian P, Enderle MD, Wendel HP, Salewski C, Popov AF, Linzenbold W, Schlensak C. Hydrojet-Based Delivery of IPSC-Derived Autologous Cardiomyocytes into the Myocardium. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gall M, van Sluijs R, Kohn B, Wiesmeyr C, Wilhelm E, Rondei Q, Jäger L, Achermann P, Landolt HP, Jenni O, Riener R, Garn H, Hill C. Analysis of sleep-related rhythmic movement disorder in children using automatic 3D detections. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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van Sluijs R, Rondei Q, Schluep D, Jäger L, Achermann P, Riener R, Wilhelm E. Effect of the intensity of rocking movements on nap sleep. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Jäger L. Dentale Erkrankungen. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1310927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Juckel G, Karch S, Kawohl W, Kirsch V, Jäger L, Leicht G, Lutz J, Stammel A, Pogarell O, Ertl M, Reiser M, Hegerl U, Möller HJ, Mulert C. Age effects on the P300 potential and the corresponding fMRI BOLD-signal. Neuroimage 2012; 60:2027-34. [PMID: 22366332 DOI: 10.1016/j.neuroimage.2012.02.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2011] [Revised: 10/31/2011] [Accepted: 02/08/2012] [Indexed: 10/28/2022] Open
Abstract
Age has been reported to influence amplitude and latency of the P300 potential. Nevertheless, it is not yet fully understood which brain regions are responsible for these effects. The aim of this study was to investigate age-effects on the P300 potential and the simultaneously acquired BOLD signal of functional MRI. 32 healthy male subjects were investigated using an auditory oddball paradigm. The functional MRI data were acquired in temporal synchrony to the task. The evoked potential data were recorded during the intervals in between MR image acquisitions in order to reduce the influence of the scanner noise on the presentation of the tones and to reduce gradient artifacts. The age-effects were calculated by means of regression analyses. In addition, brain regions modulated by the task-induced amplitude variation of the P300 were identified (single trial analysis). The results indicated an age effect on the P300 amplitude. Younger subjects demonstrated increased parietal P300 amplitudes and increased BOLD responses in a network of brain regions including the anterior and posterior cingulate cortex, the insula, the temporo-parietal junction, the superior temporal gyrus, the caudate body, the amygdala and the parahippocampal gyrus. Single trial coupling of EEG and fMRI indicated that P300 amplitudes were predominantly associated with neural responses in the anterior cingulate cortex, the putamen and temporal brain areas. Taken together, the results indicate diminished neural responses in older compared to younger subjects especially in frontal, temporo-parietal and subcortical brain regions.
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Affiliation(s)
- G Juckel
- Department of Psychiatry, Ruhr-University Bochum, Bochum, Germany.
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Jäger L. Aktuelles zur DVT. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Karch S, Leicht G, Giegling I, Lutz J, Kunz J, Buselmeier M, Hey P, Jäger L, Meindl T, Pogarell O, Hegerl U, Rujescu D, Mulert C. PW01-146 - Neuronal correlates of working memory deficits in patients with schizophrenia and their relatives. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)71545-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Arbusow V, Dieterich M, Strupp M, Dreher A, Jäger L, Brandt T. Herpes zoster neuritis involving superior and inferior parts of the vestibular nerve causes ocular tilt reaction. Neuroophthalmology 2009. [DOI: 10.1076/noph.19.1.17.3693] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Karch S, Leicht G, Giegling I, Lutz J, Kunz J, Buselmeier M, Hey P, Spörl A, Jäger L, Meindl T, Pogarell O, Hegerl U, Rujescu D, Mulert C. Inefficient working memory-related neural activity in patients with schizophrenia and their relatives. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)72086-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Abstract
Spontaneous retropharyngeal hematoma is a rare but potentially fatal disease. It occurs with no underlying medical condition such as trauma, hemorrhagic diathesis, or medically induced anticoagulation.We report a case of a 48-year-old man who presented with progressive dysphagia, signs of inflammation, and a reduced general health status. There was distinct hemorrhagic swelling of the posterior and lateral walls of the nasopharynx, oropharynx, and hypopharynx, as well as red discoloration of the neck. No underlying medical conditions, medications, or trauma were reported.In light of the current case and the available literature, we present the necessary diagnostic procedures and treatment options. Because the course of this disease might be fatal due to rapid airway obstruction and progressive internal blood loss, it is of utmost importance to keep this diagnosis in mind for differential diagnostic considerations.
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Affiliation(s)
- N Rotter
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
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Abstract
In 1904 Guiseppe Gradenigo described an infection of the apex of the petrous part of the temporal bone from acute otitis media with the clinical symptoms of unilateral pain around the eye, diplopia due to sixth nerve paralysis and persistant otorrhea. While this infection became evident by inward extension from petrositis in the majority of fatal cases from acute otitis media in the preantibiotic era, it has now become very rare. Today, cases mainly derive from cholesteatomas or chronic osteomyelitis of the petrous bone. However, due to intense antibiotic treatment in acute otitis media clinical signs of petrositis may be less typical compared to former times. We report on a 12-year-old boy with rapid onset of sixth nerve paralysis without clinical signs of acute otitis media or mastoiditis. CT and NMR imaging confirmed infection of the petrous apex. He was treated by mastoidectomy with exploration of a posterior cell group from the epitympanon around the semicircular canals and subsequent high dose intravenous antibiotics. The patient recovered without any loss of inner ear or facial nerve function. The paralysis of the sixth nerve disappeared completely within 6 weeks.
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Affiliation(s)
- P Zengel
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Klinikum Grosshadern, Ludwig-Maximilians-Universität, Marchioninistr. 15, 81377, München
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Karch S, Mulert C, Jäger L, Hermisson I, Reiser M, Möller H, Hegerl U, Pogarell O. Temporal (EEG) and spatial (fMRI) aspects of functional brain dysfunctions in schizophrenic patients. Clin Neurophysiol 2007. [DOI: 10.1016/j.clinph.2006.11.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Mulert C, Jäger L, Seifert C, Karch S, Leicht G, Möller H, Hegerl U, Pogarell O. Trial by trial coupling of simultaneous 61-channel EEG and fMRI: The N1-effect revisited. Clin Neurophysiol 2007. [DOI: 10.1016/j.clinph.2006.11.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sokollu F, Leicht G, Lutz J, Giegling I, Kirsch V, Körner K, Lang M, Karch S, Jäger L, Pogarell O, Hegerl U, Rujescu D, Mulert C. Verminderte Kapazität zur belohnungsabhängigen Leistungssteigerung und gestörte ACC-Funktion bei Patienten mit Schizophrenie: Eine simultane EEG/fMRT-Studie. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2007-976367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kirsch V, Karch S, Jäger L, Leicht G, Stammel A, Lutz J, Hegerl U, Pogarell O, Reiser M, Juckel G, Mulert C. Einfluss von Alter und Reaktionszeit auf P300-Potentiale und BOLD-Korrelate: Simultane Messung mit 61-Kanal-EEG und fMRT. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2007-976368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Stammel A, Karch S, Jäger L, Graz C, Karamatskos E, Holtschmidt-Täschner B, Flatz W, Lutz J, Leicht G, Genius J, Pogarell O, Hegerl U, Möller HJ, Reiser M, Soyka M, Mulert C. Aufmerksamkeitsdefizit bei alkoholabhängigen Patienten – Eine simultane fMRT/EEG-Studie mit dem auditorischen oddball-Paradigma. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2007-976366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Karamatskos E, Karch S, Jäger L, Graz C, Stammel A, Flatz W, Lutz J, Holtschmidt-Täschner B, Genius J, Leicht G, Pogarell O, Reiser M, Möller HJ, Hegerl U, Soyka M, Mulert C. Einfluss von Angst auf die Fähigkeit zur Verhaltensinhibition bei alkoholabhängigen Patienten. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2007-976361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mulert C, Seifert C, Jäger L, Karch S, Leicht G, Pogarell O, Moosmann M, Sokollu F, Matte O, Lutz J, Reiser M, Möller HJ, Hegerl U. Single trial Kopplung von fMRT und EEG – Analyse des N1-spezifischen BOLD-Korrelats während einer Wahlreaktionsaufgabe. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2007-976365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Buselmeier M, Karch S, Leicht G, Giegling I, Lutz J, Jäger L, Hey P, Spörl A, Pogarell O, Möller HJ, Hegerl U, Reiser M, Rujescu D, Mulert C. Arbeitsgedächtnis bei schizophrenen Patienten: Eine fMRT Studie. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2007-976363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Thalmeier T, Karch S, Jäger L, Cerovecki A, Hock B, Lutz J, Leicht G, Hegerl U, Möller HJ, Riedel M, Reiser M, Mulert C, Pogarell O. Neurophysiologische und funktionell bildgebende Untersuchungen von Verhaltenskontrollprozessen bei Patienten mit Aufmerksamkeitsdefizit- und Hyperaktivitätsstörung. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2007-976442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Seifert C, Mulert C, Jäger L, Karch S, Leicht G, Pogarell O, Moosmann M, Matte O, Lutz J, Reiser M, Möller HJ, Hegerl U. Mediale Frontallappenaktivierungen bei einer auditorischen Wahlreaktionsaufgabe im Vergleich zu einem auditorischen Go-/Nogo-Paradigma: Eine simultane EEG/fMRT- Studie. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2007-976364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hey P, Karch S, Leicht G, Giegling I, Jäger L, Lutz J, Spörl A, Buselmeier M, Möller HJ, Pogarell O, Hegerl U, Reiser M, Rujescu D, Mulert C. Frontallapentätigkeit bei Patienten mit Schizophrenie und gesunden Angehörigen: Eine simultane EEG/fMRT-Untersuchung mit dem n-back Paradigma. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2007-976369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kitzelmann IA, Feurstein A, Schiemer A, Jäger L, Menz W, Simma B. Vernetzungsarbeit der Kinderschutzgruppe Feldkirch in Vorarlberg, Österreich. Monatsschr Kinderheilkd 2007. [DOI: 10.1007/s00112-005-1241-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Jäger L. Entzündungen. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-976741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mulert C, Jäger L, Seifert C, Karch S, Leicht G, Möller HJ, Hegerl U, Pogarell O. Trial by trial coupling of simultaneous 61-channel EEG and fMRI: The N1-effect revisited. KLIN NEUROPHYSIOL 2006. [DOI: 10.1055/s-2006-939239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Karch S, Mulert C, Jäger L, Hermisson I, Reiser M, Möller HJ, Hegerl U, Pogarell O. Temporal (EEG) and spatial (fMRI) aspects of functional brain dysfunctions in schizophrenic patients. KLIN NEUROPHYSIOL 2006. [DOI: 10.1055/s-2006-939193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lutz J, Jäger L. Entzündungen des Hirnstamms und des Kleinhirnbrückenwinkels. Radiologe 2006; 46:205-15. [PMID: 16450145 DOI: 10.1007/s00117-006-1339-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Inflammatory lesions of the brainstem and the cerebellopontine angle are often critical for the patient, because crucial neuronal and vascular structures are found in this region. The patient's prognosis mainly depends on rapid identification of the inflammation site and the radiological evaluation of the inflammation pathogenesis to develop therapeutic strategies. Therefore, cross-sectional imaging is complementary to laboratory and CSF analysis as well as biopsies. This article gives a survey of inflammatory lesions of the brainstem and the cerebellopontine angle.
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Affiliation(s)
- J Lutz
- Institut für Klinische Radiologie, Klinikum Grosshadern der Ludwig-Maximilians-Universität München
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Jäger L. Bildgebende Diagnostik angeborener Veränderungen. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
PURPOSE To examine the influence of cardiac activity-related head movements and varying blood pulse frequencies on the shape of electroencephalography (EEG) recordings in a high magnetic field, and to implement a post-processing technique to eliminate cardiac activity-related artifacts. MATERIAL AND METHODS Respiratory thoracic movements, changes of blood pulse frequency and passive head movements of 20 healthy subjects were examined outside and inside an MR magnet at rest in a simultaneously recorded 21-channel surface EEG. An electrocardiogram (ECG) was recorded simultaneously. On the basis of the correlation of the left ventricular ejection time (LVET) with the heart-rate, a post-processing heart-rate dependent subtraction of the cardiac activity-related artifacts of the EEG was developed. The quality of the post-processed EEG was tested by detecting alpha-activity in the pre- and post-processed EEGs. RESULTS Inside the magnet, passive head motion but not respiratory thoracic movements resulted in EEG artifacts that correlated strongly with cardiac activity-related artifacts of the EEG. The blood pulse frequency influenced the appearance of the cardiac activity-related artifacts of the EEG. The removal of the cardiac activity-related artifacts of the EEG by the implemented post-processing algorithm resulted in an EEG of diagnostic quality with detected alpha-activity. CONCLUSION When recording an EEG in MR environment, heart rate-dependent subtraction of EEG artifacts caused by ballistocardiogram contamination is essential to obtain EEG recordings of diagnostic quality and reliability.
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Affiliation(s)
- L Jäger
- Institut für Klinische Radiologie, Klinikum Grosshadern, Universität München.
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Flatz H, Jäger L, Hempel MJ, Brüning R, Helmberger R, Schoenberg S, Reiser M. Detektion and Abgrenzung laryngealer und hypopharyngealer Tumoren mittels Multidetektor-CT und MRT mit paralleler Bildgebung. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Jäger L, Mulert C, Propp S, Karch S, Reiser M. Lautstärkeabhängigkeit des primären Hörkortex: Simultane fMRT- und EEG-Messung. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Jäger L, Lutz J, Stahl R, Dietrich O, Schelling G, Schoenberg S, Reiser M. Kortikale und subkortikale Veränderungen bei Patienten mit CRPS (Complex Regional Pain Syndrome): Eine DTI-Studie. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
Niikawa-Kuroki syndrome (Kabuki make-up syndrome) is a congenital disorder with characteristic facial features and possibly anomalies of the skeletal system and internal organs. There is an increasing number of reports of patients with combined hearing impairment, inner ear deformities or sensorineural hearing impairment. In addition, the patients often suffer from therapy-resistant chronic otitis media. In addition to multiple cardiac and renal deformities, our 3 year old patient has a hearing impairment due to chronic otitis media with chronic otorrhea, and requires a hearing aid. A high-definition CT scan of the petrosal bone revealed, for the first time in a patient with Niikawa-Kuroki syndrome, a large vestibular aqueduct syndrome and deformities of the vestibular system. We examine the problems involved with treating chronic otorrhea in chronic otitis media and providing patients with BTE hearing aids.
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Affiliation(s)
- J M Hempel
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde der Ludwig-Maximilians-Universität München.
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Karch S, Mulert C, Jäger L, Teutsch M, Seifert C, Propp S, Pogarell O, Möller H, Hegerl U. Neurobiological Correlates of Disturbed Cognitive Functions in Patients with Schizophrenia: A Simultaneous EEG + fMRI Study. KLIN NEUROPHYSIOL 2004. [DOI: 10.1055/s-2004-832037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Mulert C, Jäger L, Propp S, Leicht G, Pogarell O, Juckel G, Hegerl U. Loudness dependency of the primary auditory cortex as an indicator of central serotonergic transmission: Combination of EEG and fMRI. Pharmacopsychiatry 2004. [DOI: 10.1055/s-2003-825444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Flatz W, Jäger L, Teipel SJ, Stöckel S, Dietrich O, Schönberg SO, Leinsinger G, Reiser M. Poster zum Thema „Neuroradiologie“ (MRT, Andere) MR-Analyse der Substantia Innominata bei Alzheimerscher Krankheit und normalem Altern. ROFO-FORTSCHR RONTG 2004. [DOI: 10.1055/s-2004-828545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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38
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Abstract
A patient sought treatment for vertical oscillopsia and impaired vision during locomotion, and unsteadiness of gait. Positive fistula tests and CT of the temporal bones confirmed a diagnosis of bilateral superior canal dehiscence. An impairment of the superior canal vestibulo-ocular reflex, documented by three-dimensional search coil eye movement recordings for oblique (single) and downward pitch head motion (bilateral canal testing), is proposed to induce vertical rather than torsional-vertical oscillopsia during locomotion.
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Affiliation(s)
- A Deutschländer
- Department of Neurology, Institute of Clinical Radiology, Klinikum Grosshadern, Ludwig-Maximilians University, Munich, Germany.
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Mulert C, Jäger L, Pogarell O, Bussfeld P, Schmitt R, Juckel G, Hegerl U. Simultaneous ERP and event-related fMRI: focus on the time course of brain activity in target detection. Methods Find Exp Clin Pharmacol 2003; 24 Suppl D:17-20. [PMID: 12575464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
The event-related P300 potential has been widely used in neurophysiological research. It is usually evoked with an oddball paradigm. One main reason for its broad application in neurophysiological research is the fact that in several brain/mental diseases, such as Alzheimer's disease or schizophrenia, attenuations of the P300 amplitude and latency have been described. However, a precise correlation of the scalp data to the underlying brain regions was not possible, as the correct localization of the generators of scalp-measured electroencephalogram (EEG) data was limited, due to the low spatial resolution of EEG-data. With the availability of modern imaging technologies, functional Magnetic Resonance Imaging (fMRI) in particular, the underlying brain activations could be detected using an oddball task. Although the spatial resolution of fMRI is excellent, the time resolution is restricted. For a comprehensive understanding of the brain activity underlying the P300 paradigm, we have used a combination of EEG and fMRI to get a precise localization and a high-time resolution of the underlying brain activity.
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Affiliation(s)
- C Mulert
- Laboratory for Clinical Neurophysiology, Department of Psychiatry, LMU, Munich, Germany.
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Pöpperl G, Lang S, Dagdelen O, Jäger L, Tiling R, Hahn K, Tatsch K. [Correlation of FDG-PET and MRI/CT with histopathology in primary diagnosis, lymph node staging and diagnosis of recurrency of head and neck cancer]. ROFO-FORTSCHR RONTG 2002; 174:714-20. [PMID: 12063600 DOI: 10.1055/s-2002-32215] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
AIM Correct staging of head and neck cancer is important for the patient's prognosis and further therapeutic strategies. Aim of the present study was to investigate the diagnostic value of FDG-PET regarding the pre-surgical diagnosis of primary tumor and cervical lymph node metastases, the diagnosis of tumour recurrence, and the localisation of unknown primary, further to compare the results to those of morphological imaging modalities (CT/MRI) and to correlate the results of both methods with histopathological findings. PATIENTS/METHODS 115 patients (pts) (72 x primary diagnosis, 37 x recurrence, and 6 x unknown primary) underwent FDG-PET (ECAT EXACT HR+) and CT or MRI. Results were correlated with histopathological findings in terms of detection of primary and recurrent tumors as well as lymph node metastases. RESULTS Regarding the pre-surgical diagnosis, sensitivity and specificity for identifying primary tumors were 85 % and 100 % for PET and 88 % and 75 % for CT/MRI, respectively. Accuracy was 86 % for PET and 87 % for CT/MRI. Sensitivity and specificity for detecting primary lymph node involvement were 71 %/86 % for PET and 74 %/57 % for CT/MRI, resulting in an accuracy of 77 % with PET and 68 % with morphological imaging. In 23 pts histopathology revealed pT1 stages with tumor diameters < 12 mm. In 8 pts CT/MRI and in 10 pts PET failed to identify these small primary lesions. Detecting tumor recurrence (n = 37) PET showed a higher sensitivity (83 %), specificity (76 %) and accuracy (78 %) compared to CT/MRI (sensitivity: 67 %; specificity: 52 %; accuracy: 57 %). In 4/6 pts with unknown primary, imaging was able to identify a primary lesion (3/4 in FDG-PET, 2/4 in CT/MRI), in 2/6 patients even in the follow-up no primary tumor was found. CONCLUSIONS FDG-PET provides only minor additional information to morphological imaging concerning diagnosis of primary tumors. At a similar level of sensitivity, however, it seems to be more specific regarding the lymph node involvement. PET seems to be superior to CT/MRI in detecting tumor recurrence as well as occult primary tumors in pts with known cervical lymph node metastases.
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Affiliation(s)
- G Pöpperl
- Klinik und Poliklinik für Nuklearmedizin; München, Germany.
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Abstract
INTRODUCTION Before sinus surgery, computed tomography (CT) of the paranasal sinuses and anterior skull base is a standard procedure in the diagnostic evaluation. However, coronal sections necessary for the analysis of the complex anatomy of this region are often not applicable in multiple injured or elderly patients due to the impossibility to maintain the required position for the coronal scans. Secondary coronal reconstruction of primary axially acquired scans could help to overcome this problem. This technique was, however, hampered so far by an insufficient resolution in case of conventional CT. We therefore compared the quality of primary coronally acquired conventional CT images with the resolution of multiplanar reformatted coronal images of primary axially acquired scans by means of a new CT generation, the Multidetector Computed Tomography (MDCT). MATERIAL AND METHODS 10 patients were each examined with conventional CT or MDCT respectively. The quality of primary coronally acquired conventional scans (CT) versus secondary coronal reconstructions (MDCT) was compared by evaluating typical anatomic landmarks. RESULTS As compared to conventional CT, the coronal reconstruction of primary axially acquired scans by means of MDCT revealed an equal resolution and additionally no essential impairment by amalgam artefacts. CONCLUSION Our results demonstrate the excellent quality of secondary coronal reconstructions by means of MDCT in the CT evaluation of the paranasal sinuses and the anterior skull base as compared to primary coronally acquired images via conventional CT.
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Affiliation(s)
- S Lang
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenkranke, Germany
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Maurizot V, Jäger L, Kolbe A, Wagner C, Taillefer M, Cristau HJ. Crystal and molecular structure of the resonance stabilized azaylide Ph 2 P[NC(O)Ph]NHC(O)Ph and its IR spectroscopic characterization. J Mol Struct 2002. [DOI: 10.1016/s0022-2860(01)00956-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Tauber S, Jäger L, Issing WJ. [Follow-up assessment of intratympanic gentamicin therapy and Saccotomia in Menière's Disease]. Laryngorhinootologie 2002; 81:335-41. [PMID: 12001022 DOI: 10.1055/s-2002-28344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND The intratympanic application of ototoxic antibiotics and saccotomia have been well documented in severe cases of one-sided Menière's disease for 30 years now. Both treatment methods are still subject to controversial discussion. PATIENTS AND MATERIAL This study includes 8 patients suffering from persistent one-sided Menière's disease after treatment with gentamicin application and additional saccotomia (n=2). We performed follow-up visits including the assessment of hearing ability, vestibular function and cranial MRI, 2-10 years after onset of treatment. RESULTS After therapeutic interventions 7 patients reported to be healed of their symptom vertigo. In 4 patients the gentamicin-treated vestibular organ did not respond to thermic stimulus at the time of follow-up examination. Auditory threshold shift was observed in 3 patients (1 permanent, 2 temporary), whereas hearing threshold improved in 2 patients. Tinnitus was attenuated in 3 patients, while 1 patient suffered from posttherapeutic onset of tinnitus. Morphological and structural changes due to Menière's disease and treatment procedures were ruled out by cranial MRI. CONCLUSION The intratympanic application of ototoxic medication is a safe and effective treatment method in severe cases of Menière's disease. Saccotomia should be considered as therapeutic regimen for persistent symptoms after repeated application of gentamicin.
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Affiliation(s)
- S Tauber
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenkranke, Ludwig-Maximilians-Universität München, Germany
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Abstract
Computed tomography (CT) and magnetic resonance imaging (MRI) are well established imaging modalities to examine the facial nerve as well as the course of the facial nerve itself. High spatial resolution is guaranteed not only in the x- and y-axis, but also in the z-axis using multislice spiral CT. With this technique, reformatted multiplanar images in oblique planes, avoiding additional examinations in the coronal plane, facilitate the delineation of the facial nerve canal. This is beneficial in patients with temporal bone trauma, malformation or osseous changes. MR has a superior soft-tissue contrast to CT that enables imaging of the facial nerve itself. Therefore the normal facial nerve as well as pathologic changes of the facial nerve is readily visualized from the brain stem to the parotid gland. This review article presents anatomy, pathology and imaging strategies in the diagnostics of the facial nerve.
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Affiliation(s)
- L Jäger
- University of Munich, Institute of Clinical Radiology, Klinik Grosshadern, Marchioninistr. 15, 81366 Munich, Germany.
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Fahlbusch B, Hornung D, Heinrich J, Jäger L. Predictors of group 5 grass-pollen allergens in settled house dust: comparison between pollination and nonpollination seasons. Allergy 2001; 56:1081-6. [PMID: 11703223 DOI: 10.1034/j.1398-9995.2001.00106.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Some sensitive pollen-allergic patients may experience perennial symptoms, and for these patients it is vitally important to know the concentration of grass-pollen allergens in their homes. The main objective of this study was to detect predictors associated with high grass allergen concentration in settled house dust during and outside the grass pollination season. METHODS We detected group 5 grass-pollen allergens in dust samples from randomly selected homes of three counties in the region of Sachsen-Anhalt: Hettstedt (n=183), Zerbst (n=152), and Bitterfeld (n=119). Dust samples were collected from the floors of living rooms (LR) and children's rooms (CR) from April 1996 to March 1998. RESULTS Phl p 5 was detected in settled house dust in 91% of the homes. The range was between undetectable (<30 ng/m2) and 4300 ng Phl p 5/m2 sampling area during grass pollination, and 1300 ng Phl p 5/m2 outside the pollination season, respectively. We observed a partially higher concentration of indoor allergenic activity several weeks after the grass-pollen peak. A positive association was found between Phl p 5 levels and total dust amounts throughout the year. Thus, we assume that grass allergens accumulate in settled house dust. During pollination, the Phl p 5 levels are 1.8 times higher in homes where vacuuming of carpets takes place only once a week or less than in those vacuumed daily. Furthermore, higher concentrations of Phl p 5 in settled floor dust can be expected in homes located within suburban areas (mean ratio [MR] 1.74) and prefabricated slab buildings (MR=1.54). CONCLUSIONS Quite high levels of Phl p 5 accumulate in settled house dust even during periods when no grass pollen is present in the atmosphere. The removal of dust by frequent cleaning reduces the indoor exposure to grass allergens. Such information is essential to train patients in allergen avoidance.
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Affiliation(s)
- B Fahlbusch
- Friedrich-Schiller-University, Institute of Clinical Immunology, Jena, GSF - National Research Center for Environment and Health, Institute of Epidemiology, Neuherberg, Germany
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Abstract
Computed tomography (CT) and magnetic resonance imaging (MRI) are well established imaging modalities to examine the TMJ. MRI is superior to CT in delineating the morphological architecture of the TMJ, not only in cases of normal anatomy, inflammation or tumors, but also if dysfunction of the TMJ is present. This review article presents anatomy as well as imaging strategies of the TMJ.
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Affiliation(s)
- L Jäger
- Institut für Klinische Radiologie, Universität München, Klinikum Grosshadem, Marchioninistr. 15, 81366 München.
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Jäger L, Wagner C, Korabik M, Zygmunt A, Mroziński J. Crystal structure, magnetism and spectroscopy of bis(tetraphenylphosphonium)tetrakis(dicyanamido)cobaltate(II) with bridging and pendant dicyanamide ligands. J Mol Struct 2001. [DOI: 10.1016/s0022-2860(01)00491-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sülün T, Cemgil T, Duc JM, Rammelsberg P, Jäger L, Gernet W. Morphology of the mandibular fossa and inclination of the articular eminence in patients with internal derangement and in symptom-free volunteers. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001; 92:98-107. [PMID: 11458253 DOI: 10.1067/moe.2001.114621] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate temporomandibular joint morphology and to compare possible structural variations in the temporomandibular joint anatomy of symptomatic anterior disk displacement patients with possible structural variations in the temporomandibular joint anatomy of symptom-free volunteers. STUDY DESIGN Fifty-six symptomatic patients and 25 symptom-free volunteers were included in this study. All subjects had bilateral high-resolution magnetic resonance imaging scans performed in the sagittal (closed and open) positions. Disk positions were evaluated with these images, and the patients were accordingly classified into 4 diagnostic groups. The angulation between the Frankfort horizontal plane and the posterior slope of the articular eminence, as well as the width and depth of the glenoid fossa and the articular tuberculum, were automatically measured with the aid of a computer. RESULTS The Mann-Whitney U test demonstrated significant differences in the angular and linear values obtained in disk displacement with reduction patients in comparison with the values obtained in patients with disk displacement without reduction and in symptom-free volunteers. CONCLUSION It is proposed that a steeper posterior slope and higher tuberculum articulaire are predisposing factors for the development of disk displacement with reduction. Flattening of the eminence may progress in time, leading to the onset of disk displacement without reduction.
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Affiliation(s)
- T Sülün
- Department of Prosthetic Dentistry, University of Istanbul, Turkey
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Potocnák I, Dunaj-Jurco M, Miklos D, Massa W, Jäger L. Bis(2,2'-bipyridine)(dicyanamido)copper(II) tetrafluoroborate. Acta Crystallogr C 2001; 57:363-5. [PMID: 11313559 DOI: 10.1107/s0108270100020503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2000] [Accepted: 12/18/2000] [Indexed: 11/10/2022] Open
Abstract
In the title compound, [Cu(C(2)N(3))(C(10)H(8)N(2))(2)]BF(4), the Cu(II) atom shows distorted trigonal-bipyramidal geometry, with the dicyanamido ligand in the equatorial plane. The two out-of-plane Cu-N bond lengths to bipyridine are 2.006 (3) and 1.998 (3) A, whereas the in-plane Cu-N distances are 2.142 (3) and 2.043 (3) A to the bipyridine, and 2.015 (3) A to the dicyanamide.
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Affiliation(s)
- I Potocnák
- Department of Inorganic Chemistry, Faculty of Science, PJ Safárik University, Moyzesova 11, 041 54 Kosice, Slovakia.
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Abstract
BACKGROUND It is widely known and accepted that grass pollen is a major outdoor cause of hay fever. However, it is of virtual importance for grass pollen allergic patients with symptoms all the year round to know the concentration of grass pollen allergens in their homes. OBJECTIVE The main objective of this study was to quantify the amount of grass pollen allergen in mass units (microg Phl p 5) in dust settled indoors and to detect the distribution of allergenic activity in different sampling locations of homes. Furthermore, we studied the seasonal fluctuation of allergen content in dust samples. METHODS We adapted the two site binding assay for detection of group 5 grass pollen allergens in samples from randomly selected homes in Hamburg (n = 371), Erfurt (n = 396), Hettstedt (n = 353), Zerbst (n = 289) and Bitterfeld (n = 226), Germany. Dust samples were collected from floor of living room (LR), bedroom (BR) or children's room (CR) and mattress (MA) during period of June 1995 to August 1998. The amount of the major grass group 5 allergens was detected in microg/g dust. RESULTS Phl p 5 was detected in 67% of the samples analysed (n = 4760). The range was between undetectable (< 0.03 microg/g dust) and 81 microg/g dust. Phl p 5 levels were significantly higher in the dust from LR (geometric mean 0.117 microg/g dust) or BR/CR floors (geometric mean 0.098 microg/g dust) than in mattresses (geometric mean 0.043 microg/g dust). We observed seasonal fluctuation of indoor Phl p 5 levels with peak in June but also annual differences. Thus Phl p 5 content indoors reflects also the different quantities of pollen counts of annual courses. During pollination period we found two times higher Phl p 5 levels (0.172 microg/g dust, P < 0.001) than outside of grass pollination season (0.095 microg/g dust). The indoor Phl p 5 levels outside of season seem to be independent of pollination before. We suppose that settled pollen grains or allergenic material from outdoor particles carried indoors via footwear and clothes accumulates in house dust. CONCLUSION Although we not known how the allergens in settled dust are equilibrated with those in the air, the considerable high level of Phl p 5 in indoor dust even during periods when no grass pollen is present in the atmosphere may be an important cause of pollen-allergy symptoms outside of season.
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Affiliation(s)
- B Fahlbusch
- Friedrich Schiller University, Institute of Clinical Immunology, Jena, Germany
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