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6. Treatment outcome of IDH1/2 wildtype CNS WHO grade 4 glioma histologically diagnosed as WHO grade II or III astrocytomas

Author

Keric, Naureen, Krenzlin, Harald, Kalasauskas, Darius, Freyschlag, Christian F., Schnell, Oliver, Misch, Martin, von der Brelie, Christian, Gempt, Jens, Krigers, Aleksandrs, Wagner, Arthur, Lange, Felipa, Mielke, Dorothee, Sommer, Clemens, Brockmann, Marc A., Meyer, Bernhard, Rohde, Veit, Vajkoczy, Peter, Beck, Jürgen, Thomé, Claudius, and Ringel, Florian

Published
2024
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9. Effects of argon in the acute phase of subarachnoid hemorrhage in an endovascular perforation model in rats

Author

Krenzlin, Harald, primary, Wesp, Dominik M. A., additional, Korinek, Anika A. E., additional, Ubbens, Henning, additional, Volland, Jakob, additional, Masomi-Bornwasser, Julia, additional, Weber, Katharina J., additional, Mole, Dominik, additional, Sommer, Clemens, additional, Ringel, Florian, additional, Alessandri, Beat, additional, and Keric, Naureen, additional

Published
2024
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14. Microsurgical Clipping of Unruptured Anterior Circulation Aneurysms—A Global Multicenter Investigation of Perioperative Outcomes

Author

Sauvigny, Jennifer, primary, Drexler, Richard, additional, Pantel, Tobias F., additional, Ricklefs, Franz L., additional, Catapano, Joshua S., additional, Wanebo, John E., additional, Lawton, Michael T., additional, Sanchin, Aminaa, additional, Hecht, Nils, additional, Vajkoczy, Peter, additional, Raygor, Kunal, additional, Tonetti, Daniel, additional, Abla, Adib, additional, El Naamani, Kareem, additional, Tjoumakaris, Stavropoula I., additional, Jabbour, Pascal, additional, Jankowitz, Brian T., additional, Salem, Mohamed M., additional, Burkhardt, Jan-Karl, additional, Wagner, Arthur, additional, Wostrack, Maria, additional, Gempt, Jens, additional, Meyer, Bernhard, additional, Gaub, Michael, additional, Mascitelli, Justin R., additional, Dodier, Philippe, additional, Bavinzski, Gerhard, additional, Roessler, Karl, additional, Stroh, Nico, additional, Gmeiner, Matthias, additional, Gruber, Andreas, additional, Figueiredo, Eberval G., additional, Coelho, Antonio Carlos Samaia da Silva, additional, Bervitskiy, Anatoliy V., additional, Anisimov, Egor D., additional, Rzaev, Jamil A., additional, Krenzlin, Harald, additional, Keric, Naureen, additional, Ringel, Florian, additional, Park, Dougho, additional, Kim, Mun-Chul, additional, Marcati, Eleonora, additional, Cenzato, Marco, additional, Krause, Linda, additional, Westphal, Manfred, additional, Dührsen, Lasse, additional, and Sauvigny, Thomas, additional

Published
2024
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20. Glioma patients in outpatient care—optimization of psychosocial care in neuro-oncological patients (GLIOPT): Protocol for a cluster randomized controlled trial

Author

Renovanz, Mirjam, Hippler, Melina, Voss, Martin, Wehinger, Jens, Keßler, Almuth F., Gempt, Jens, Nadji-Ohl, Minou, Weiß Lucas, Carolin, Rapp, Marion, Misch, Martin, Coburger, Jan, Mehlitz, Marcus, Meixensberger, Jürgen, Keric, Naureen, Tabatabai, Ghazaleh, Blettner, Maria, Schranz, Melanie, and Singer, Susanne

Published
2020
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23. Global Outcomes for Microsurgical Clipping of Unruptured Intracranial Aneurysms: A Benchmark Analysis of 2245 Cases

Author

Drexler, Richard, Sauvigny, Thomas, Pantel, Tobias F., Ricklefs, Franz L., Catapano, Joshua S., Wanebo, John E., Lawton, Michael T., Sanchin, Aminaa, Hecht, Nils, Vajkoczy, Peter, Raygor, Kunal, Tonetti, Daniel, Abla, Adib, El Naamani, Kareem, Tjoumakaris, Stavropoula I., Jabbour, Pascal, Jankowitz, Brian T., Salem, Mohamed M., Burkhardt, Jan-Karl, Wagner, Arthur, Wostrack, Maria, Gempt, Jens, Meyer, Bernhard, Gaub, Michael, Mascitelli, Justin R., Dodier, Philippe, Bavinzski, Gerhard, Roessler, Karl, Stroh, Nico, Gmeiner, Matthias, Gruber, Andreas, Figueiredo, Eberval G., da Silva Coelho, Antonio Carlos Samaia, Bervitskiy, Anatoliy V., Anisimov, Egor D., Rzaev, Jamil A., Krenzlin, Harald, Keric, Naureen, Ringel, Florian, Park, Dougho, Kim, Mun-Chul, Marcati, Eleonora, Cenzato, Marco, Westphal, Manfred, Dührsen, Lasse, Drexler, Richard, Sauvigny, Thomas, Pantel, Tobias F., Ricklefs, Franz L., Catapano, Joshua S., Wanebo, John E., Lawton, Michael T., Sanchin, Aminaa, Hecht, Nils, Vajkoczy, Peter, Raygor, Kunal, Tonetti, Daniel, Abla, Adib, El Naamani, Kareem, Tjoumakaris, Stavropoula I., Jabbour, Pascal, Jankowitz, Brian T., Salem, Mohamed M., Burkhardt, Jan-Karl, Wagner, Arthur, Wostrack, Maria, Gempt, Jens, Meyer, Bernhard, Gaub, Michael, Mascitelli, Justin R., Dodier, Philippe, Bavinzski, Gerhard, Roessler, Karl, Stroh, Nico, Gmeiner, Matthias, Gruber, Andreas, Figueiredo, Eberval G., da Silva Coelho, Antonio Carlos Samaia, Bervitskiy, Anatoliy V., Anisimov, Egor D., Rzaev, Jamil A., Krenzlin, Harald, Keric, Naureen, Ringel, Florian, Park, Dougho, Kim, Mun-Chul, Marcati, Eleonora, Cenzato, Marco, Westphal, Manfred, and Dührsen, Lasse

Abstract

BACKGROUND AND OBJECTIVES: Benchmarks represent the best possible outcome and help to improve outcomes for surgical procedures. However, global thresholds mirroring an optimal and reachable outcome for microsurgical clipping of unruptured intracranial aneurysms (UIA) are not available. This study aimed to define standardized outcome benchmarks in patients who underwent clipping of UIA. METHODS: A total of 2245 microsurgically treated UIA from 15 centers were analyzed. Patients were categorized into low- ("benchmark") and high-risk ("nonbenchmark") patients based on known factors affecting outcome. The benchmark was defined as the 75th percentile of all centers' median scores for a given outcome. Benchmark outcomes included intraoperative (eg, duration of surgery, blood transfusion), postoperative (eg, reoperation, neurological status), and aneurysm-related factors (eg, aneurysm occlusion). Benchmark cutoffs for aneurysms of the anterior communicating/anterior cerebral artery, middle cerebral artery, and posterior communicating artery were determined separately. RESULTS: Of the 2245 cases, 852 (37.9%) patients formed the benchmark cohort. Most operations were performed for middle cerebral artery aneurysms (53.6%), followed by anterior communicating and anterior cerebral artery aneurysms (25.2%). Based on the results of the benchmark cohort, the following benchmark cutoffs were established: favorable neurological outcome (modified Rankin scale ≤2) ≥95.9%, postoperative complication rate ≤20.7%, length of postoperative stay ≤7.7 days, asymptomatic stroke ≤3.6%, surgical site infection ≤2.7%, cerebral vasospasm ≤2.5%, new motor deficit ≤5.9%, aneurysm closure rate ≥97.1%, and at 1-year follow-up: aneurysm closure rate ≥98.0%. At 24 months, benchmark patients had a better score on the modified Rankin scale than nonbenchmark patients. CONCLUSION: This study presents internationally applicable benchmarks for clinically relevant outcomes after microsurgical clipping of UIA.

Published
2023

24. In vitro testing of a funnel-tip catheter with different clot types to decrease clot migration in mechanical thrombectomy.

Author

Payne, Emily S., Krost-Reuhl, Samantha, Heimann, Axel, Keric, Naureen, Masomi-Bornwasser, Julia, Gerber, Tiemo, Seidman, Larissa, Kirschner, Stefanie, Brockmann, Marc A., and Tanyildizi, Yasemin

Subjects
THROMBECTOMY, STROKE patients, CATHETERS, ABRUPTIO placentae
Abstract

Background: Mechanical thrombectomy is the standard treatment for acute ischemic stroke in patients with large vessel occlusion and can be performed up to 24h after symptom onset. Despite high recanalization rates, embolism in new territories has been reported in 8.6% of the cases. Causes for this could be clot abruption during stent retrieval into the smaller opening of a standard distal access catheter, and antegrade blood flow via collaterals despite proximal balloon protection. A funnel-shaped tip with a larger internal diameter was developed to increase the rate of first-pass recanalization and to improve the safety and efficacy of mechanical thrombectomy. Methods: This in vitro study compared the efficacy of a funnel-shaped tip with a standard tip in combination with different clot compositions. Mechanical thrombectomy was performed 80 times for each tip, using two stent retrievers (Trevo XP ProVue 3/20 mm, 4/20 mm) and four different clot types (hard vs. soft clots, 0–24h vs. 72h aged clots). Results: Significantly higher first-pass recanalization rates (mTICI 3) were observed for the funnel-shaped tip, 70.0% versus 30.0% for the standard tip (absolute difference, 32; relative difference 57.1%; P <.001), regardless of the clot type and stent retriever. Recanalization could be increased using harder Chandler loop clots versus softer statically generated clots, as well as 0–24h versus 72h aged clots, respectively. Conclusion: The funnel-shaped tip achieved higher first-pass recanalization rates than the smaller standard tip and lower rates of clot abruption at the tip. Clot compositions and aging times impacted recanalization rates. [ABSTRACT FROM AUTHOR]

Published
2023
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29. The role of surgery in IDH wildtype diffuse astrocytomas

Author

Krenzlin, Harald, primary, Lange, Felipa, additional, Dauth, Alice, additional, Kalasauskas, Darius, additional, Freyschlag, Christian, additional, Schnell, Oliver, additional, Misch, Martin, additional, Brelie, Christian von der, additional, Krigers, Aleksandrs, additional, Rohde, Veit, additional, Vajkoczy, Peter, additional, Jürgen, Beck, additional, Thomé, Claudius, additional, Ringel, Florian, additional, and Keric, Naureen, additional

Published
2023
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36. A Rapid Late Enhancement MRI Protocol Improves Differentiation between Brain Tumor Recurrence and Treatment-Related Contrast Enhancement of Brain Parenchyma

Author

Satvat, Neda, primary, Korczynski, Oliver, additional, Müller-Eschner, Matthias, additional, Othman, Ahmed E., additional, Schöffling, Vanessa, additional, Keric, Naureen, additional, Ringel, Florian, additional, Sommer, Clemens, additional, Brockmann, Marc A., additional, and Reder, Sebastian, additional

Published
2022
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39. Mechanismen des Cytomegalovirus zur Überwindung der Blut-Hirn-Schranke beim Glioblastom

Author

Krenzlin, Harald, Schmidt, Leon, Berenz, Thomas, Lemmermann, Niels, Lawler, Sean, Ringel, Florian, and Keric, Naureen

Subjects
ddc: 610, Medicine and health, virus diseases
Abstract

Objective: Cytomegalovirus (CMV) has been linked to glioblastoma for over a decade. However, mechanisms of how CMV tumor infection occurs are poorly understood. After infection, CMV persists in mononuclear myeloid and dendritic cell progenitors. Here we identify possible transmission pathways involving [for full text, please go to the a.m. URL]

Published
2022

40. Gammasonde-gestützte Resektion der intrakraniellen Meningeome, eine Machbarkeitsstudie

Author

Kalasauskas, Darius, Baqué, Pia Elisabeth, Reber, Helmut, Conrad, Jens, Schwandt, Eike, Keric, Naureen, Schreckenberger, Mathias, and Ringel, Florian

Subjects
ddc: 610, fungi, Medicine and health, otorhinolaryngologic diseases, food and beverages, neoplasms, nervous system diseases
Abstract

Objective: Meningioma resection in case of intraosseous and intramuscular expansion or the differentiation between relapsed tumor and scar tissue can be challenging, as the tumor margin may be difficult to identify. Somatostatin receptor (SSTR-2) is expressed by meningioma and can be used for visualization [for full text, please go to the a.m. URL]

Published
2022
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41. Gebrechlichkeit sowie das Volumen des Muskulus temporalis sind Prädiktoren für das Ansprechen auf die Immuntherapie und das Gesamtüberleben bei Patienten mit Hirnmetastasen bei NSCLC

Author

Krenzlin, Harald, Ringel, Florian, and Keric, Naureen

Subjects
ddc: 610, Medicine and health, respiratory tract diseases
Abstract

Objective: Brain metastases occur in up to 40% of patients with advanced non-small-cell lung cancer (NSCLC) and are ause of death in half of the cases. Therapy with checkpoint inhibitors (CPI) has activity in brain metastases with PD-L1 expression of at least 1%. As lung cancer is diagnosed [for full text, please go to the a.m. URL]

Published
2022

42. Einfluss von spinaler Muskelmasse, Knochendichte und Frailty auf den Erfolg einer dorsalen Spondylodese bei osteoporotischen Wirbelkörperfrakturen

Author

Schmidt, Leon, Jankovic, Dragan, Ringel, Florian, Krenzlin, Harald, and Keric, Naureen

Subjects
ddc: 610, Medicine and health
Abstract

Objective: Osteoporosis is the most common age-related progressive skeletal disease characterized by bone loss and a predisposition for osteoporotic vertebral fractures. The management often necessitates fusion surgery, with high rates of implant failure. We aim to determine the impact of frailty, sarcopenia, [for full text, please go to the a.m. URL]

Published
2022

48. Evaluation of 3D Robotic-Guided Exoscopic Visualization in Microneurosurgery

Author

Keric, Naureen, Krenzlin, Harald, Kurz, Elena, Wesp, Dominik M. A., Kalasauskas, Darius, and Ringel, Florian

Subjects
Surgery
Abstract

ObjectiveThe three-dimensional (3D) exoscope is a novel apparatus introduced in recent years. Although an operating microscope (OM) is customarily used, this novel application offers several advantages. Therefore, this study aimed to determine the feasibility of deploying a robotic-guided 3D-exoscope for microneurosurgery and gauge its subsequent performance.MethodsThe use of a 3D exoscope was compared with that of OM during 16 surgical procedures. Postoperatively, surgeons completed an eight-item Likert-scale satisfaction survey. As a second step, a predefined surgical task was then undertaken by surgeons with varying levels of experience, assessing the time entailed. Two questionnaires, the satisfaction survey and NASA task load index (NASA-TLX), were administered.ResultsDuring routine procedures, the exoscope proved superior in magnification and ergonomic maintenance, showing inferior image contrast, quality, and illumination. It again ranked higher in magnification and ergonomic maintenance during the suturing task, and the OM excelled in treatment satisfaction and stereoscopic orientation. Workload assessment using the NASA-TLX revealed no difference by modality in the pairwise analysis of all components. At varying levels of experience, beginners bear a significantly higher burden in all principle components than mid-level and expert participants (p = 0.0018). Completion times for the suturing task did not differ (p = 0.22).ConclusionThe quality of visualization by 3D exoscope seems adequate for treatment and its ergonomic benefit is superior to that of OM. Although experienced surgeons performed a surgical simulation faster under the OM, no difference was evident in NASA-TLX surveys. The 3D exoscope is an excellent alternative to the OM.

Published
2021

49. Soluble neuregulin-1 modulates disease pathogenesis in rodent models of Charcot-Marie-Tooth disease 1A

Author

Fledrich, Robert, Stassart, Ruth M., Klink, Axel, Rasch, Lennart M., Prukop, Thomas, Haag, Lauren, Czesnik, Dirk, Kungl, Theresa, Abdelaal, Tamer A.M., Keric, Naureen, Stadelmann, Christine, Bruck, Wolfgang, Nave, Klaus-Armin, and Sereda, Michael W.

Subjects
Charcot-Marie-Tooth disease -- Research -- Analysis -- Development and progression, Biological sciences, Health
Abstract

Duplication of the gene encoding the peripheral myelin protein of 22 kDa (PMP22) underlies the most common inherited neuropathy, Charcot-Marie-Tooth 1A (CMT1A) (1-3), a disease without a known cure (4-6). Although demyelination represents a characteristic feature, the clinical phenotype of CMT1A is determined by the degree of axonal loss, and patients suffer from progressive muscle weakness and impaired sensation (4,7). CMT1A disease manifests within the first two decades of life (8,9), and walking disabilities, foot deformities and electrophysiological abnormalities are already present in childhood (7-11). Here, we show in Pmp22-transgenic rodent models of CMT1A that Schwann cells acquire a persistent differentiation defect during early postnatal development, caused by imbalanced activity of the PI3K-Akt and the Mek-Erk signaling pathways. We demonstrate that enhanced PI3K-Akt signaling by axonally overexpressed neuregulin-1 (NRG1) type I drives diseased Schwann cells toward differentiation and preserves peripheral nerve axons. Notably, in a preclinical experimental therapy using a CMT1A rat model, when treatment is restricted to early postnatal development, soluble NRG1 effectively overcomes impaired peripheral nerve development and restores axon survival into adulthood. Our findings suggest a model in which Schwann cell differentiation within a limited time window is crucial for the long-term maintenance of axonal support., The early onset of CMT neuropathy symptoms in childhood (7-11) prompted us to investigate postnatal Schwann cell development in transgenic CMT1A model rats (Sprague Dawley rats expressing Tg(Pmp22)Kan). These rats [...]

Published
2014

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