University Hospital of Magdeburg

Magdeburg, Germany

University Hospital of Magdeburg

Magdeburg, Germany
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Kraft M.,Head and Neck Surgery | Arens C.,University Hospital of Magdeburg
Progress in Biomedical Optics and Imaging - Proceedings of SPIE | Year: 2013

Introduction: Endoscopic imaging can be used in the assessment of cancer and precancerous lesions of the upper aerodigestive tract. The objective of this presentation is to describe vertical imaging methods. Methods: The working principle and technique of optical coherence tomography (OCT) as well as endosonography (EUS) are briefly illustrated. Results: The main indications, normal and pathologic findings of each method, frequent pitfalls, and clinical results up to now are presented in detail. Conclusions: Endosonography helps in determining the exact extension of advanced carcinomas beyond 3 mm, while OCT, due to its better resolution, is superior in the assessment of precancerous and early cancerous lesions up to 2 mm thickness.


Kraft M.,Head and Neck Surgery | Arens C.,University Hospital of Magdeburg
Optics InfoBase Conference Papers | Year: 2013

Introduction: Endoscopic imaging can be used in the assessment of cancer and precancerous lesions of the upper aerodigestive tract. The objective of this presentation is to describe vertical imaging methods. Methods: The working principle and technique of optical coherence tomography (OCT) as well as en-dosonography (EUS) are briefly illustrated. Results: The main indications, normal and pathologic findings of each method, frequent pitfalls, and clinical results up to now are presented in detail. Conclusions: Endosonography helps in determining the exact extension of advanced carcinomas be-yond 3 mm, while OCT, due to its better resolution, is superior in the assessment of precancerous and early cancerous lesions up to 2 mm thickness. © 2013 OSA-SPIE.


Kraft M.,Kantonsspital AG | Bruns N.,University Hospital of Magdeburg | Hugens-Penzel M.,Klinikum Kassel GmbH | Arens C.,University Hospital of Magdeburg
Head and Neck | Year: 2013

Background Endosonography has been successfully used in staging gastrointestinal cancer, but its value is as yet undetermined in laryngology. Methods This prospective study includes 84 patients undergoing microlaryngoscopy for laryngeal cancer. The results of endosonography were compared with those of CT and MRI in the 76 surgical cases. Results In the assessment of laryngal cancer, endosonography was superior to current imaging techniques, whereas CT and MRI showed similar results (accuracy of 89% vs 77% and 77%, respectively). Conclusions This study confirms that endosonography is highly effective in staging laryngeal cancer. Therefore, the latter may constitute a complementary diagnostic tool in these tumors and additionally may assist in choosing an adequate treatment. © 2012 Wiley Periodicals, Inc.


Rezaei N.,Tehran University of Medical Sciences | Rezaei N.,University of Sheffield | Sabbaghian M.,Tehran University of Medical Sciences | Liu Z.,Nanjing Medical University | Zenker M.,University Hospital of Magdeburg
European Journal of Pediatrics | Year: 2011

Johanson-Blizzard syndrome is a very rare autosomal recessive disorder caused by mutations in the Ubiquitin-Protein Ligase E3 Component N-Recognin 1 (UBR1) gene. The syndrome is characterized by exocrine pancreatic insufficiency and a wide range of additional clinical features, including aplasia or hypoplasia of the alae nasi, oligodontia, sensorineural hearing loss, hypothyroidism, scalp defects, mental retardation, and developmental delay. Several other abnormalities in different organs, particularly anorectal, urogenital, and cardiac anomalies have been reported since the first description of this syndrome four decades ago. UBR1 gene defects are underlying the disease. Only symptomatic treatment is available. Exocrine pancreas insufficiency plus abnormal alae nasi is pathognomonic for Johanson-Blizzard syndrome. © 2010 Springer-Verlag.


Hentschke C.M.,Otto Von Guericke University of Magdeburg | Beuing O.,University Hospital of Magdeburg | Paukisch H.,University Hospital of Magdeburg | Scherlach C.,University Hospital of Magdeburg | And 2 more authors.
Medical Physics | Year: 2014

Purpose: The early detection of cerebral aneurysms plays a major role in preventing subarachnoid hemorrhage. The authors present a system to automatically detect cerebral aneurysms in multimodal 3D angiographic data sets. The authors' system is parametrizable for contrast-enhanced magnetic resonance angiography (CE-MRA), time-of-flight magnetic resonance angiography (TOF-MRA), and computed tomography angiography (CTA). Methods: Initial volumes of interest are found by applying a multiscale sphere-enhancing filter. Several features are combined in a linear discriminant function (LDF) to distinguish between true aneurysms and false positives. The features include shape information, spatial information, and probability information. The LDF can either be parametrized by domain experts or automatically by training. Vessel segmentation is avoided as it could heavily influence the detection algorithm. Results: The authors tested their method with 151 clinical angiographic data sets containing 112 aneurysms. The authors reach a sensitivity of 95% with CE-MRA data sets at an average false positive rate per data set (FPDS) of 8.2. For TOF-MRA, we achieve 95% sensitivity at 11.3 FPDS. For CTA, we reach a sensitivity of 95% at 22.8 FPDS. For all modalities, the expert parametrization led to similar or better results than the trained parametrization eliminating the need for training. 93% of aneurysms that were smaller than 5 mm were found. The authors also showed that their algorithm is capable of detecting aneurysms that were previously overlooked by radiologists. Conclusions: The authors present an automatic system to detect cerebral aneurysms in multimodal angiographic data sets. The system proved as a suitable computer-aided detection tool to help radiologists find cerebral aneurysms. © 2014 American Association of Physicists in Medicine.


Nullmeier S.,Otto Von Guericke University of Magdeburg | Panther P.,University Hospital of Magdeburg | Frotscher M.,Institute for Structural Neurobiology | Zhao S.,Institute for Structural Neurobiology | Schwegler H.,Otto Von Guericke University of Magdeburg
Neuroscience | Year: 2014

The heterozygous reeler mouse (HRM), haploinsufficient for reelin, shares several neurochemical and behavioral similarities with patients suffering from schizophrenia. It has been shown that defective reelin signaling influences the mesolimbic dopaminergic pathways in a specific manner. However, there is only little information about the impact of reelin haploinsufficiency on the monoaminergic innervation of different brain areas, known to be involved in the pathophysiology of schizophrenia. In the present study using immunocytochemical procedures, we investigated HRM and wild-type mice (WT) for differences in the densities of tyrosine hydroxylase (TH)-immunoreactive (IR) and serotonin (5-HT)-IR fibers in prefrontal cortex, ventral and dorsal hippocampal formation, amygdala and ventral and dorsal striatum. We found that HRM, compared to WT, shows a significant increase in TH-IR fiber densities in dorsal hippocampal CA1, CA3 and ventral CA1. In contrast, HRM exhibits a significant decrease of TH-IR in the shell of the nucleus accumbens (AcbShell), but no differences in the other brain areas investigated. Overall, no genotype differences were found in the 5-HT-IR fiber densities. In conclusion, these results support the view that reelin haploinsufficiency differentially influences the catecholaminergic (esp. dopaminergic) systems in brain areas associated with schizophrenia. The reelin haploinsufficient mouse may provide a useful model for studying the role of reelin in hippocampal dysfunction and its effect on the dopaminergic system as related to schizophrenia. © 2014 IBRO.


Schott B.H.,Leibniz Institute for Neurobiology | Schott B.H.,University Hospital of Magdeburg | Schott B.H.,Charite University Hospital | Wustenberg T.,Charite University Hospital | And 10 more authors.
Human Brain Mapping | Year: 2013

New episodic memory traces represent a record of the ongoing neocortical processing engaged during memory formation (encoding). Thus, during encoding, deep (semantic) processing typically establishes more distinctive and retrievable memory traces than does shallow (perceptual) processing, as assessed by later episodic memory tests. By contrast, the hippocampus appears to play a processing-independent role in encoding, because hippocampal lesions impair encoding regardless of level of processing. Here, we clarified the neural relationship between processing and encoding by examining hippocampal-cortical connectivity during deep and shallow encoding. Participants studied words during functional magnetic resonance imaging and freely recalled these words after distraction. Deep study processing led to better recall than shallow study processing. For both levels of processing, successful encoding elicited activations of bilateral hippocampus and left prefrontal cortex, and increased functional connectivity between left hippocampus and bilateral medial prefrontal, cingulate and extrastriate cortices. Successful encoding during deep processing was additionally associated with increased functional connectivity between left hippocampus and bilateral ventrolateral prefrontal cortex and right temporoparietal junction. In the shallow encoding condition, on the other hand, pronounced functional connectivity increases were observed between the right hippocampus and the frontoparietal attention network activated during shallow study processing. Our results further specify how the hippocampus coordinates recording of ongoing neocortical activity into long-term memory, and begin to provide a neural explanation for the typical advantage of deep over shallow study processing for later episodic memory. Hum Brain Mapp, 2013. © 2011 Wiley Periodicals, Inc.


Kraft M.,Kantonsspital AG | Betz C.S.,Ludwig Maximilians University of Munich | Leunig A.,Ludwig Maximilians University of Munich | Arens C.,University Hospital of Magdeburg
Head and Neck | Year: 2011

Background Fluorescence endoscopy is used for the early detection and delineation of laryngeal cancer and its precursor lesions. No systematic review of these promising imaging techniques has yet been performed. Methods A systematic review of the published literature and meta-analysis of data extracted from 16 included studies were performed. A total of 1000 laryngeal lesions were examined by autofluorescence endoscopy (AFE), 318 mucosal changes by induced fluorescence endoscopy (IFE), and 679 laryngeal pathologies underwent normal white light endoscopy (WLE). Results In identifying precancerous and cancerous lesions of the larynx, sensitivity (91% vs 73%), specificity (84% vs 79%), and accuracy (88% vs 77%) of AFE were superior to WLE alone, whereas IFE showed an even higher sensitivity (95% vs 73%) at the expense of specificity (62% vs 79%). Therefore, AFE also achieved a higher specificity (84% vs 62%) and accuracy (88% vs 76%) than did IFE in detecting these kinds of lesions. However, the sensitivity (91% vs 95%) did not differ significantly between both methods. Conclusions This meta-analysis confirms that fluorescence endoscopy is highly effective in the early diagnosis of laryngeal cancer and its precursor lesions. Thus, AFE can be used immediately without drug administration or possible side effects, whereas IFE is more suited for the detection of recurrent disease following initial surgery. © 2010 Wiley Periodicals, Inc.


Gazis A.,University Hospital of Magdeburg | Beuing O.,University Hospital of Magdeburg | Jollenbeck B.,University Hospital of Magdeburg | Franke J.,University Hospital of Magdeburg | Skalej M.,University Hospital of Magdeburg
Spine | Year: 2012

Study Design: Case report. Objective: To avoid neuronal damage by using the bipolar radio frequency ablation of spinal tumors. Summary of Background Data: Radio frequency ablation of tumorous masses is an established procedure and is increasingly used as pain therapy of unresectable spine tumors. Ablation of lesions adjacent to vulnerable structures remains a challenging task because flow of current is insufficiently controlled by monopolar probes. Using this technique, a prediction of the induced necrosis accurate to the millimeter is not feasible. Methods: Three patients with metastases of the spine were treated using the bipolar radio frequency ablation. Results: In all 3 cases collateral damage of neuronal structures could be avoided even though tumorous masses touched the cauda equina or were very close to vulnerable structures, respectively. The induction of necrosis was predictable to the millimeter. Conclusion: Ablation of tumorous masses adjacent to neural structures by bipolar technique, is feasible and predictable. Spinal cord damage can be avoided by exact planning of the induced necrosis.


Gazis A.N.,University Hospital of Magdeburg | Beuing O.,University Hospital of Magdeburg | Franke J.,University Hospital of Magdeburg | Jollenbeck B.,University Hospital of Magdeburg | Skalej M.,University Hospital of Magdeburg
Spine Journal | Year: 2014

Background: Bone metastases are often the cause of tumor-associated pain and reduction of quality of life. For patients that cannot be treated by surgery, a local minimally invasive therapy such as radiofrequency ablation can be a useful option. In cases in which tumorous masses are adjacent to vulnerable structures, the monopolar radiofrequency can cause severe neuronal damage because of the unpredictability of current flow. Purpose: The aim of this study is to show that the bipolar radiofrequency ablation provides an opportunity to safely treat such spinal lesions because of precise predictability of the emerging ablation zone. Study design: Prospective cohort study of 36 patients undergoing treatment at a single institution. Patient sample: Thirty-six patients in advanced tumor stage with primary or secondary tumor involvement of spine undergoing radiofrequency ablation. Outcome measures: Prediction of emerging ablation zone. Clinical outcome of treated patients. Methods: X-ray-controlled treatment of 39 lesions by bipolar radiofrequency ablation. Magnetic resonance imaging was performed pre- and postinterventionally. Patients were observed clinically during their postinterventional stay. Results: The extent of the ablation zones was predictable to the millimeter because it did not cross the peri-interventional planned dorsal and ventral boundaries in any case. No complications were observed. Conclusions: Ablation of tumorous masses adjacent to vulnerable structures is feasible and predictable by using the bipolar radiofrequency ablation. Damage of neuronal structures can be avoided through precise prediction of the ablation area. © 2014 Elsevier Inc. All rights reserved.

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