Showing papers by "Ulrich Bogdahn published in 2004"

Neuroplasticity: changes in grey matter induced by training.

Abstract: Newly honed juggling skills show up as a transient feature on a brain-imaging scan. Does the structure of an adult human brain alter in response to environmental demands1,2? Here we use whole-brain magnetic-resonance imaging to visualize learning-induced plasticity in the brains of volunteers who have learned to juggle. We find that these individuals show a transient and selective structural change in brain areas that are associated with the processing and storage of complex visual motion. This discovery of a stimulus-dependent alteration in the brain's macroscopic structure contradicts the traditionally held view that cortical plasticity is associated with functional rather than anatomical changes.

Vascular Neurotoxicity Following Chemotherapy with Cisplatin, Ifosfamide, and Etoposide

Abstract: OBJECTIVETo report a case of acute central nervous system (CNS) toxicity with multiple hemorrhages restricted to the corpus callosum associated with combination therapy of cisplatin, ifosfamide, and etoposide.CASE SUMMARYA 38-year-old white man with a testicular germ cell tumor received a cisplatin-based chemotherapy consisting of cisplatin 45 mg (20 mg/m2), etoposide 570 mg (250 mg/m2), and ifosfamide 4600 mg (2000 mg/m2) given on 5 consecutive days during each course. After the first course of chemotherapy, the patient appeared to be neuropsychologically impaired with episodes of decreased alertness and features of a depressive syndrome. He became severely diminished in mental function, orientation, and psychomotor activity after a second course of treatment. In addition, he showed transient urinary incontinence. Motor and sensory deficits could not be detected. Magnetic resonance imaging demonstrated multiple hemorrhages restricted to the corpus callosum. An objective causality assessment revealed that...

High-resolution MR imaging of the rat spinal cord in vivo in a wide-bore magnet at 17.6 Tesla

Abstract: The objective was to demonstrate the feasibility and to evaluate the performance of high-resolution in vivo magnetic resonance (MR) imaging of the rat spinal cord in a 17.6-T vertical wide-bore magnet. A probehead consisting of a surface coil that offers enlarged sample volume suitable for rats up to a weight of 220 g was designed. ECG triggered and respiratory-gated gradient echo experiments were performed on a Bruker Avance 750 wide-bore spectrometer for high-resolution imaging. With T*2 values between 5 and 20 ms, good image contrast could be obtained using short echo times, which also minimizes motion artifacts. Anatomy of healthy spinal cords and pathomorphological changes in traumatically injured rat spinal cord in vivo could be visualized with microscopic detail. It was demonstrated that imaging of the rat spinal cord in vivo using a vertical wide-bore high-magnetic-field system is feasible. The potential to obtain high-resolution images in short scan times renders high-field imaging a powerful diagnostic tool.

Maintenance therapy with 13-cis retinoid acid in high-grade glioma at complete response after first-line multimodal therapy--a phase-II study.

Abstract: Background: Approximately 5% of patients with malignant glioma achieve complete response (CR) after first-line combined modality treatment. Although these patients will invariably suffer from tumor recurrence, they usually do not receive any further treatment to maintain remission. According to in vitro and in vivo clinical studies, 13-cis retinoic acid (cRA) may be a promising agent for maintenance therapy in these patients.

Intraventricular cytarabine in a case of idiopathic hypertrophic pachymeningitis

Abstract: Idiopathic hypertrophic chronic pachymeningitis (IHCP) is characterised by inflammatory fibrotic thickening of the dura mater. Long term management is controversial. A 28 year old man with craniospinal IHCP and prominent lymphocytic meningitis is reported. Cerebrospinal fluid and histological examination suggested a CD4+ T cell driven process and B cell stimulation. After surgical, tuberculostatic, and immunosuppressive treatment failed to control the progressive meningeal hypertrophy, causing severe headache and neurological disability, the disease process eventually abated with intraventricular cytarabine treatment.

Specific therapy for high-grade glioma by convection-enhanced delivery of the TGF-β2 specific antisense oligonucleotide AP 12009.

Abstract: 1514 Background: High-grade gliomas are highly aggressive tumors showing marked transforming growth-factor-beta2 (TGF-β2) overexpression inducing proliferation, metastasis, angiogenesis and in particular immunosuppression. Methods: In 3 phase I/II dose escalation studies adult high-grade glioma patients (WHO III/IV) with recurrent tumor and evidence of tumor progression on MRI were treated with AP 12009, a TGF-β2 specific phosphorothioate antisense oligonucleotide. AP 12009 was administered intratumorally by convection enhanced delivery (CED) in 3 studies in up to 12 cycles. In the 3rd study, an indwelling pump system was used that allowed repeated treatment cycles with a single catheter placement on an out-patient basis. Safety and tolerability were primary endpoints. Secondary endpoint was clinical efficacy. Results: In only 5 of the total 24 patients “possibly” related adverse events were observed, mostly of grade 1 or 2, one was classified as serious. There were no relevant changes in laboratory value...

Expression levels of melanoma inhibitory activity correlate with time to progression in patients with high-grade glioma.

Abstract: Melanoma inhibitory activity (MIA) is related to disease progression in patients with malignant melanoma and to invasion and metastasis of melanoma in vivo and in vitro. An alternative splice product termed MIA(splice) was described recently. In addition to melanoma, both proteins are expressed in a substantial subset of high-grade gliomas. We hypothesize that expression levels of both proteins correlate with early tumor progression and parameters of disseminated disease in patients with high-grade glioma. We examined the correlation of expression levels of MIA and MIA(splice) with time to progression and morphological and clinical markers of disseminated disease (defined as multifocal occurrence, gliomatosis, invasion or metastasis) in a series of 24 newly-diagnosed human high-grade gliomas. Homogenates of surgical specimens, cell cultures and blood samples were analyzed. Significant levels of MIA and MIA(splice) protein were detected in 71% of homogenates of high-grade glioma, but not in the related blood samples. Patients with early tumor progression had lower expression levels of MIA than patients with late progression, and the expression level of MIA was inversely related to time to progression. In addition, MIA expression correlated with a high fiber content of the extracellular matrix, suggesting a role in dissemination as known from malignant melanoma. Expression levels of MIA in homogenates of surgical specimen directly relate to a more benign clinical prognosis in patients with high-grade glioma. While a mechanistic relation has not yet been verified, factors such as a high fiber content of the extracellular matrix may explain this observation.

Telemedicine stroke department network. Introduction of a telemedicine pilot project for integrated stroke management in South Bavaria and analysis of its efficiency

Abstract: Trotz uber 100 Stroke Units in Deutschland besteht in landlichen Gebieten derzeit keine ausreichende stationare Schlaganfallversorgung. Ziel des „Telemedizinischen Pilotprojektes zur integrierten Schlaganfallversorung (TEMPiS)“ ist daher eine flachendeckende Qualitatsforderung der Schlaganfallbehandlung in Sudostbayern. Die 12 beteiligten Kooperationskliniken mit neu eingerichteten spezialisierten Schlaganfallstationen sind mittels Breitbandvideokonferenz und digitaler Bildubertragung telemedizinisch mit den Schlaganfallzentren in Munchen-Harlaching und Regensburg vernetzt. Uber die rund um die Uhr verfugbaren Telekonsultationen mit Patientenuntersuchung vor der Kamera kann die Beurteilung diagnostischer Fragestellungen und Festlegung des weiteren Prozederes gemeinsam erfolgen. Zur Evaluation der Effizienz werden in einer kontrollierten Vergleichsanalyse 5 reprasentative TEMPiS-Kooperationskliniken mit 5 Krankenhausern entsprechender Grose, Ausstattung und Versorgungsregion verglichen. Fur ca. ein Jahr werden in diesen Kliniken alle Schlaganfallpatienten prospektiv dokumentiert und neben Schlaganfallschweregrad und epidemiologischen Parametern die Behandlungsdaten festgehalten. Nach 3 bzw. 12 Monaten werden der primare Endpunkt Tod/institutionalisierte Pflege sowie die funktionellen Outcome-Parameter modified Rankin Scale, Barthel-Index und EQ-5D erhoben. Der Patienteneinschluss hat im Juli 2003 begonnen.

Adjuvant chemotherapy with temozolomide and liposomal doxorubicin in the first-line therapy of patients with glioblastoma: A phase-II trial

Abstract: 1539 Background: Temozolomide (TMZ; Temodal/Temodar) recently showed promising results in the first-line therapy of glioblastoma (Stupp R, 2004). Pegylated liposomal doxorubicin (PEG-Dox; Caelyx/Do...

“Fußkribbeln“, Vergesslichkeit und progrediente Wesensveränderung bei einer 63-jährigen Patientin = "Tingling feet," forgetfulness, and progressive personality changes in a 63-year-old patient

Abstract: A 63-year-old female was admitted to the hospital with leg and forearm paresthesias. We found progressive ataxia, dementia, and psychosocial deterioration. The clinical symptoms, the neurologic and psychiatric abnormalities together with the inflammatory cerebrospinal fluid alteration and the cerebral magnetic resonance imaging changes suggested a paraneoplastic etiology. It was confirmed by paraneoplastic antineuronal antibodies in the patient's serum and the histological diagnosis of a small cell bronchial carcinoma. The prognosis of patients with paraneoplastic symptoms is the better the earlier a diagnosis is established and antitumor therapy is initiated.

"Fußkribbeln", Vergesslichkeit und progrediente Wesensveränderung bei einer 63-jährigen Patientin.

Abstract: A 63-year-old female was admitted to the hospital with leg and forearm paresthesias. We found progressive ataxia, dementia, and psychosocial deterioration. The clinical symptoms, the neurologic and psychiatric abnormalities together with the inflammatory cerebrospinal fluid alteration and the cerebral magnetic resonance imaging changes suggested a paraneoplastic etiology. It was confirmed by paraneoplastic antineuronal antibodies in the patient's serum and the histological diagnosis of a small cell bronchial carcinoma. The prognosis of patients with paraneoplastic symptoms is the better the earlier a diagnosis is established and antitumor therapy is initiated.

Corrigendum: Hypothalamic gray matter changes in narcoleptic patients

Abstract: Nat. Med. 8, 1186–1188 (2002) Because of space constraints, a reference was omitted from the text. The following sentence should have appeared after sentence 5 in paragraph 3: “However, Kaufmann et al. have described changes in gray matter structures in 12 narcoleptic patients10.” Subsequent references should be renumbered accordingly.