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Raposo N, Zanon Zotin MC, Schoemaker D, Xiong L, Fotiadis P, Charidimou A, Pasi M, Boulouis G, Schwab K, Schirmer MD, Etherton MR, Gurol ME, Greenberg SM, Duering M, Viswanathan A. Peak Width of Skeletonized Mean Diffusivity as Neuroimaging Biomarker in Cerebral Amyloid Angiopathy. AJNR Am J Neuroradiol 2021; 42:875-881. [PMID: 33664113 DOI: 10.3174/ajnr.a7042] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/20/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND PURPOSE Whole-brain network connectivity has been shown to be a useful biomarker of cerebral amyloid angiopathy and related cognitive impairment. We evaluated an automated DTI-based method, peak width of skeletonized mean diffusivity, in cerebral amyloid angiopathy, together with its association with conventional MRI markers and cognitive functions. MATERIALS AND METHODS We included 24 subjects (mean age, 74.7 [SD, 6.0] years) with probable cerebral amyloid angiopathy and mild cognitive impairment and 62 patients with MCI not attributable to cerebral amyloid angiopathy (non-cerebral amyloid angiopathy-mild cognitive impairment). We compared peak width of skeletonized mean diffusivity between subjects with cerebral amyloid angiopathy-mild cognitive impairment and non-cerebral amyloid angiopathy-mild cognitive impairment and explored its associations with cognitive functions and conventional markers of cerebral small-vessel disease, using linear regression models. RESULTS Subjects with Cerebral amyloid angiopathy-mild cognitive impairment showed increased peak width of skeletonized mean diffusivity in comparison to those with non-cerebral amyloid angiopathy-mild cognitive impairment (P < .001). Peak width of skeletonized mean diffusivity values were correlated with the volume of white matter hyperintensities in both groups. Higher peak width of skeletonized mean diffusivity was associated with worse performance in processing speed among patients with cerebral amyloid angiopathy, after adjusting for other MRI markers of cerebral small vessel disease. The peak width of skeletonized mean diffusivity did not correlate with cognitive functions among those with non-cerebral amyloid angiopathy-mild cognitive impairment. CONCLUSIONS Peak width of skeletonized mean diffusivity is altered in cerebral amyloid angiopathy and is associated with performance in processing speed. This DTI-based method may reflect the degree of white matter structural disruption in cerebral amyloid angiopathy and could be a useful biomarker for cognition in this population.
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Affiliation(s)
- N Raposo
- From the Stroke Research Center (N.R., M.C.Z.Z., D.S., L.X., P.F., A.C., K.S., M.D.S., M.R.E., M.E.G., S.M.G., A.V.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts .,Department of Neurology (N.R.), Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,Toulouse NeuroImaging Center (N.R.), Université de Toulouse, Institut National de la Santé et de la Recherche Médicale, Toulouse, UPS, France
| | - M C Zanon Zotin
- From the Stroke Research Center (N.R., M.C.Z.Z., D.S., L.X., P.F., A.C., K.S., M.D.S., M.R.E., M.E.G., S.M.G., A.V.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Center for Imaging Sciences and Medical Physics (M.C.Z.Z.). Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil;, Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, São Paulo, Brazil
| | - D Schoemaker
- From the Stroke Research Center (N.R., M.C.Z.Z., D.S., L.X., P.F., A.C., K.S., M.D.S., M.R.E., M.E.G., S.M.G., A.V.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - L Xiong
- From the Stroke Research Center (N.R., M.C.Z.Z., D.S., L.X., P.F., A.C., K.S., M.D.S., M.R.E., M.E.G., S.M.G., A.V.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - P Fotiadis
- From the Stroke Research Center (N.R., M.C.Z.Z., D.S., L.X., P.F., A.C., K.S., M.D.S., M.R.E., M.E.G., S.M.G., A.V.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - A Charidimou
- From the Stroke Research Center (N.R., M.C.Z.Z., D.S., L.X., P.F., A.C., K.S., M.D.S., M.R.E., M.E.G., S.M.G., A.V.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - M Pasi
- Department of Neurology (M.P.), Centre Hospitalier Universitaire de Lille, Lille, France
| | - G Boulouis
- Department of Neuroradiology (G.B.), Centre Hospitalier Sainte-Anne, Université Paris-Descartes, Paris, France
| | - K Schwab
- From the Stroke Research Center (N.R., M.C.Z.Z., D.S., L.X., P.F., A.C., K.S., M.D.S., M.R.E., M.E.G., S.M.G., A.V.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - M D Schirmer
- From the Stroke Research Center (N.R., M.C.Z.Z., D.S., L.X., P.F., A.C., K.S., M.D.S., M.R.E., M.E.G., S.M.G., A.V.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Computer Science and Artificial Intelligence Lab (M.D.S.), Massachusetts Institute of Technology, Boston, Massachusetts.,Department of Population Health Sciences (M.D.S.), German Center for Neurodegenerative Diseases, Bonn, Germany
| | - M R Etherton
- From the Stroke Research Center (N.R., M.C.Z.Z., D.S., L.X., P.F., A.C., K.S., M.D.S., M.R.E., M.E.G., S.M.G., A.V.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - M E Gurol
- From the Stroke Research Center (N.R., M.C.Z.Z., D.S., L.X., P.F., A.C., K.S., M.D.S., M.R.E., M.E.G., S.M.G., A.V.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - S M Greenberg
- From the Stroke Research Center (N.R., M.C.Z.Z., D.S., L.X., P.F., A.C., K.S., M.D.S., M.R.E., M.E.G., S.M.G., A.V.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - M Duering
- Medical Image Analysis Center and Quantitative Biomedical Imaging Group (M.D.), Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - A Viswanathan
- From the Stroke Research Center (N.R., M.C.Z.Z., D.S., L.X., P.F., A.C., K.S., M.D.S., M.R.E., M.E.G., S.M.G., A.V.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Ivins B, Arrieux J, Cole W, Schwab K. B-45 Base Rates of Low Scores on a Traditional Battery of Neuropsychological Tests in Soldiers with and without Acute mTBI. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
It is not uncommon for healthy individuals to have one or more low scores on a battery of cognitive tests. The number of scores produced by the battery by itself can affect the probability of having low scores. The purpose of this study is to examine the rates of low scores on a battery of commonly used neuropsychological tests in soldiers with and without acute mTBI.
Methods
Data from 246 healthy soldiers and 177 soldiers evaluated within seven days of sustaining a mTBI and who had complete and valid data were used in this analysis. All soldiers completed the TOPF, WAIS-IV, CVLT-II, RCFT, DKEFS, and CPT-II. The CARB was used as a measure of effort. For each group, we determined the proportions of soldiers who had various numbers of scores that were 1.0 or more, 1.5 or more, 2.0 or more standard deviations below the normative means for each score. We used prevalence ratios to compare the proportions with low scores in each group.
Results
Low scores were common in both groups (93.1% and 96.0% of controls and mTBI cases, respectively, had at least one score 1.0+ SDs below norm, 57.7% and 79.1% had at least one score 1.5+ SDs below norm, while 30.5% and 48.0% had at least score 2.0+ SDs below norm). Low scores were more common in the mTBI group.
Conclusion
Examining rates of low scores can help identify clinically meaningful performance decrements across an entire battery when large numbers of scores are available.
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Ivins B, Arrieux J, Cole W, Schwab K. B-74 Using Rates of Low Scores to Assess Agreement between ANAM4 TBI-MIL and a Traditional Battery of Neuropsychological Tests. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
The Automated Neurological Assessment Metrics (Version 4) Traumatic Brain Injury Military (ANAM4 TBI-MIL) battery is widely used by the US military to assess cognitive function. We compare intra-individual agreement between ANAM4 TBI-MIL and a battery of traditional neuropsychological tests using rates of low scores.
Methods
Complete and valid data from 246 healthy soldiers and 177 soldiers ≤7 days from sustaining mild TBI (mTBI) were used in this analysis. All soldiers were consecutively administered ANAM4 TBI-MIL and a traditional test battery consisting of: TOPF, WAIS-IV, CVLT-II, RCFT, DKEFS, and CPT-II. We performed base rate analyses of both batteries to determine the proportions of soldiers who had various numbers of scores that were 1.0+, 1.5+, and 2.0+ standard deviations below the normative mean. We used those rates to place Soldiers into a “low score hierarchy” ranging from the least poor (i.e. ~≥10th %ile) to the worst overall performance (i.e. ~≤10th %ile). We then compared agreement between the batteries at each of those levels.
Results
More soldiers with mTBI had low scores than healthy soldiers on both batteries. Of the soldiers who performed at the worst level on one battery, 88.1% from ANAM and 100% from traditional had some level of poor performance on the other battery. However, of the soldiers who performed at the worst level on either battery, only 58.3% from ANAM and 50.0% from traditional also performed at the worst level on the other battery.
Conclusion
These batteries similarly identify poor performance to a degree, though with some potentially meaningful differences still present.
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Ahrens A, Cole W, Schwab K. Adult Concussion - 1
Commonly Used IQ Measures and Their Suitability in Predictive Models of Cognitive Impairment After Concussion. Arch Clin Neuropsychol 2018. [DOI: 10.1093/arclin/acy060.19] [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: 11/14/2022] Open
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Ivins B, Arrieux J, Schwab K, Cole W. B - 54Agreement Between Brief Computerized Neurocognitive Assessment Tools and a Traditional Measure of Executive Function at Clinically Meaningful Performance Levels. Arch Clin Neuropsychol 2018. [DOI: 10.1093/arclin/acy061.130] [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: 11/13/2022] Open
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Eiselt M, Schelenz C, Witte H, Schwab K. Time-variant Parametric Estimation of Transient Quadratic Phase Couplings during Electroencephalographic Burst Activity. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1633980] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Summary
Objectives:
Electroencephalographic burst activity characteristic of burst-suppression pattern (BSP) in sedated patients and of burst-interburst pattern (BIP) in the quiet sleep of healthy neonates have similar linear and non-linear signal properties. Strong interrelations between a slow frequency component and rhythmic, spindle-like activities with higher frequencies have been identified in previous studies. Time-varying characteristics of BSP and BIP prevent a definite pattern-related analysis. A continuous estimation of the bispectrum is essential to analyze these patterns. Parametric bispectral approaches provide this opportunity.
Methods:
The adaptation of an AR model leads to a parametric bispectrum by using the transfer function of the estimated AR filter. Time-variant parametric bispectral approaches require an estimation of AR parameters which consider higher order moments to preserve phase information. Accordingly, a time-variant parametric estimation of the bispectrum was introduced. Data driven simulations were performed to provide optimal parameters. BSP (12 patients) and BIP (6 neonates) were analyzed using this novel approach.
Results:
Significant differences in the time course of burst pattern during BSP and burst-like pattern before the onset of BSP could be shown. A rhythmic quadratic phase coupling (period 10 sec) was identified during BIP in all neonates.
Conclusion:
Quadratic phase couplings during BSP increases in the time course depending on depth of sedation. The visually detected burst activity in BIP is only the temporarily observable EEG correlate of a hidden neural process. Time-variant bispectral approaches offer the possibility of a better characterization of underlying neural processes leading to improved diagnostic tools used in clinical routine.
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Schwab K, Leung H, Smith A, Ali K. 303 Early Identification and Intervention in Patients With Atrial Fibrillation in the Emergency Department Can Significantly Improve Guideline-Based Anticoagulation and Reduce the Risk of Stroke. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.374] [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: 11/26/2022]
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Morotti A, Romero JM, Jessel MJ, Brouwers HB, Gupta R, Schwab K, Vashkevich A, Ayres A, Anderson CD, Gurol ME, Viswanathan A, Greenberg SM, Rosand J, Goldstein JN. Effect of CTA Tube Current on Spot Sign Detection and Accuracy for Prediction of Intracerebral Hemorrhage Expansion. AJNR Am J Neuroradiol 2016; 37:1781-1786. [PMID: 27197985 DOI: 10.3174/ajnr.a4810] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 03/17/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Reduction of CT tube current is an effective strategy to minimize radiation load. However, tube current is also a major determinant of image quality. We investigated the impact of CTA tube current on spot sign detection and diagnostic performance for intracerebral hemorrhage expansion. MATERIALS AND METHODS We retrospectively analyzed a prospectively collected cohort of consecutive patients with primary intracerebral hemorrhage from January 2001 to April 2015 who underwent CTA. The study population was divided into 2 groups according to the median CTA tube current level: low current (<350 mA) and high current (≥350 mA). CTA first-pass readings for spot sign presence were independently analyzed by 2 readers. Baseline and follow-up hematoma volumes were assessed by semiautomated computer-assisted volumetric analysis. Sensitivity, specificity, positive and negative predictive values, and accuracy of spot sign in predicting hematoma expansion were calculated. RESULTS This study included 709 patients (288 and 421 in the low- and high-current groups, respectively). A higher proportion of low-current scans identified at least 1 spot sign (20.8% versus 14.7%, P = .034), but hematoma expansion frequency was similar in the 2 groups (18.4% versus 16.2%, P = .434). Sensitivity and positive and negative predictive values were not significantly different between the 2 groups. Conversely, high-current scans showed superior specificity (91% versus 84%, P = .015) and overall accuracy (84% versus 77%, P = .038). CONCLUSIONS CTA obtained at high levels of tube current showed better diagnostic accuracy for prediction of hematoma expansion by using spot sign. These findings may have implications for future studies using the CTA spot sign to predict hematoma expansion for clinical trials.
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Affiliation(s)
- A Morotti
- From the Department of Clinical and Experimental Sciences (A.M.), Neurology Clinic, University of Brescia, Brescia, Italy
- J.P. Kistler Stroke Research Center (A.M., M.J.J., K.S., A. Vashkevich, A.A., C.D.A., M.E.G., A. Viswanathan, S.M.G., J.R., J.N.G.)
| | - J M Romero
- Neuroradiology Service, Department of Radiology (J.M.R., R.G.)
| | - M J Jessel
- J.P. Kistler Stroke Research Center (A.M., M.J.J., K.S., A. Vashkevich, A.A., C.D.A., M.E.G., A. Viswanathan, S.M.G., J.R., J.N.G.)
| | - H B Brouwers
- Department of Neurosurgery (H.B.B.), Brain Center Rudolf Magnus, University Medical Center, Utrecht, the Netherlands
| | - R Gupta
- Neuroradiology Service, Department of Radiology (J.M.R., R.G.)
| | - K Schwab
- J.P. Kistler Stroke Research Center (A.M., M.J.J., K.S., A. Vashkevich, A.A., C.D.A., M.E.G., A. Viswanathan, S.M.G., J.R., J.N.G.)
| | - A Vashkevich
- J.P. Kistler Stroke Research Center (A.M., M.J.J., K.S., A. Vashkevich, A.A., C.D.A., M.E.G., A. Viswanathan, S.M.G., J.R., J.N.G.)
| | - A Ayres
- J.P. Kistler Stroke Research Center (A.M., M.J.J., K.S., A. Vashkevich, A.A., C.D.A., M.E.G., A. Viswanathan, S.M.G., J.R., J.N.G.)
| | - C D Anderson
- J.P. Kistler Stroke Research Center (A.M., M.J.J., K.S., A. Vashkevich, A.A., C.D.A., M.E.G., A. Viswanathan, S.M.G., J.R., J.N.G.)
| | - M E Gurol
- J.P. Kistler Stroke Research Center (A.M., M.J.J., K.S., A. Vashkevich, A.A., C.D.A., M.E.G., A. Viswanathan, S.M.G., J.R., J.N.G.)
| | - A Viswanathan
- J.P. Kistler Stroke Research Center (A.M., M.J.J., K.S., A. Vashkevich, A.A., C.D.A., M.E.G., A. Viswanathan, S.M.G., J.R., J.N.G.)
| | - S M Greenberg
- J.P. Kistler Stroke Research Center (A.M., M.J.J., K.S., A. Vashkevich, A.A., C.D.A., M.E.G., A. Viswanathan, S.M.G., J.R., J.N.G.)
| | - J Rosand
- J.P. Kistler Stroke Research Center (A.M., M.J.J., K.S., A. Vashkevich, A.A., C.D.A., M.E.G., A. Viswanathan, S.M.G., J.R., J.N.G.)
- Division of Neurocritical Care and Emergency Neurology (J.R., J.N.G.)
| | - J N Goldstein
- J.P. Kistler Stroke Research Center (A.M., M.J.J., K.S., A. Vashkevich, A.A., C.D.A., M.E.G., A. Viswanathan, S.M.G., J.R., J.N.G.)
- Division of Neurocritical Care and Emergency Neurology (J.R., J.N.G.)
- Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Cole W, Ivins B, Arrieux J, Schwab K, Stegman R. B-42Agreement Between Clinically Relevant Cutoffs on Neurocognitive Assessment Tools (NCATs): Preliminary Results from the DVBIC “Head to Head” Study. Arch Clin Neuropsychol 2016. [DOI: 10.1093/arclin/acw043.117] [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: 11/13/2022] Open
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Hussain M, Bailie J, Ivins B, Cole W, Boyd C, Schwab K. A-64Effect of Multiple Mild Traumatic Brain Injury on the Experience and Expression of Anger in Military Personnel. Arch Clin Neuropsychol 2015. [DOI: 10.1093/arclin/acv047.64] [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: 11/13/2022] Open
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Allen SK, Schwab K, Day A, Singh-Ranger D, Rockall TA. Laparoscopic repair of postoperative perineal hernia using a two-mesh technique. Colorectal Dis 2015; 17:O70-3. [PMID: 25523927 DOI: 10.1111/codi.12873] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 10/08/2014] [Indexed: 12/13/2022]
Abstract
AIM Perineal herniation following abdomino-perineal excision of the rectum (APER) can be debilitating. Repair options include a transabdominal (laparoscopic or open), perineal or a combined approach, but there is no consensus on the optimal technique. We describe a novel laparoscopic two-mesh technique and short- to medium-term outcomes. METHOD Six patients underwent this operation between 2008 and 2014. Patients were positioned in a modified Lloyd-Davies position, allowing perineal access, and steep Trendelenburg to aid displacement of small bowel from the pelvis. A polypropylene mesh was shaped, placed over the hernial defect, tacked postero-laterally and sutured antero-laterally to reconstitute the pelvic diaphragm. A second larger mesh (composite) was placed over the first supporting mesh and secured with tacks and sutures, overlapping the hernial defect, preventing small bowel contact with the mesh. RESULTS The median time from the index operation to presentation of the hernia was 5 months. One patient with dense small bowel adhesions from the primary repair had a combined laparoscopic and perineal approach. The median operating time was 141 min and median length of stay was 3 days. There were no intra-operative complications and no recurrences over a follow-up of 1-76 months. CONCLUSION We describe a novel laparoscopic technique for perineal hernia repair following APER with a low recurrence rate in the intermediate term.
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Affiliation(s)
- S K Allen
- Department of Colorectal Surgery, Royal Surrey County Hospital, Guildford, UK
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Smith R, Schwab K, Day A, Rockall T, Ballard K, Bailey M, Jourdan I. Effect of passive polarizing three-dimensional displays on surgical performance for experienced laparoscopic surgeons. Br J Surg 2014; 101:1453-9. [DOI: 10.1002/bjs.9601] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 02/19/2014] [Accepted: 06/03/2014] [Indexed: 01/15/2023]
Abstract
Abstract
Background
Although the potential benefits of stereoscopic laparoscopy have been recognized for years, the technology has not been adopted because of poor operator tolerance. Passive polarizing projection systems, which have revolutionized three-dimensional (3D) cinema, are now being trialled in surgery. This study was designed to see whether this technology resulted in significant performance benefits for skilled laparoscopists.
Methods
Four validated laparoscopic skills tasks, each with ten repetitions, were performed by 20 experienced laparoscopic surgeons, in both two-dimensional (2D) and 3D conditions. The primary outcome measure was the performance error rate; secondary outcome measures were time for task completion, 3D motion tracking (path length, motion smoothness and grasping frequency) and workload dimension ratings of the National Aeronautics and Space Administration (NASA) Task Load Index.
Results
Surgeons demonstrated a 62 per cent reduction in the median number of errors and a 35 per cent reduction in median performance time when using the passive polarizing 3D display compared with the 2D display. There was a significant 15 per cent reduction in median instrument path length, an enhancement of median motion smoothness, and a 15 per cent decrease in grasper frequency with the 3D display. Participants reported significant reductions in subjective workload dimension ratings of the NASA Task Load Index following use of the 3D displays.
Conclusion
Passive polarizing 3D displays improved both the performance of experienced surgeons in a simulated setting and surgeon perception of the operative field. Although it has been argued that the experience of skilled laparoscopic surgeons compensates fully for the loss of stereopsis, this study indicates that this is not the case.
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Affiliation(s)
- R Smith
- Minimal Access Therapy Training Unit, Royal Surrey County Hospital, Guildford, UK
| | - K Schwab
- Minimal Access Therapy Training Unit, Royal Surrey County Hospital, Guildford, UK
| | - A Day
- Minimal Access Therapy Training Unit, Royal Surrey County Hospital, Guildford, UK
| | - T Rockall
- Minimal Access Therapy Training Unit, Royal Surrey County Hospital, Guildford, UK
| | - K Ballard
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - M Bailey
- Minimal Access Therapy Training Unit, Royal Surrey County Hospital, Guildford, UK
| | - I Jourdan
- Minimal Access Therapy Training Unit, Royal Surrey County Hospital, Guildford, UK
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Abstract
STUDY QUESTION Does post-menopausal endometrium contain mesenchymal stem/stromal cells (MSC) that have adult stem cell properties and can be prospectively isolated from a biopsy? SUMMARY ANSWER Perivascular W5C5(+) cells isolated from post-menopausal endometrial biopsies displayed characteristic MSC properties of clonogenicity, multipotency and surface phenotype irrespective of whether the women were or were not pre-treated with estrogen to regenerate the endometrium. WHAT IS KNOWN ALREADY Recently MSCs have been identified in human premenopausal endometrium, and can be prospectively isolated using a single marker, W5C5/SUSD2. STUDY DESIGN, SIZE, DURATION Endometrial tissue of both the functional and basal layers, from 17 premenopausal (pre-MP) women, 19 post-menopausal (post-MP) women without hormonal treatment and 15 post-menopausal women on estrogen replacement therapy (post-MP+ E2), was collected through a prospective phase IV clinical trial over 2 years. PARTICIPANTS/MATERIALS, SETTING, METHODS Post-menopausal women <65 years of age were treated with or without E2 for 6-8 weeks prior to tissue collection. Serum E2 levels were determined by estradiol immunoenzymatic assay. Endometrial tissue was obtained from women by biopsy (curettage) just prior to the hysterectomy. The effect of E2 on endometrial thickness and glandular and luminal epithelial height was determined using image analysis. Endometrial tissue was dissociated into single cell suspensions and MSC properties were examined in freshly isolated and short-term cultured, magnetic bead-purified W5C5(+) cells. MSC properties were assessed using clonogenicity, serial cloning, mesodermal differentiation in adipogenic, chondrogenic, osteogenic and myogenic induction culture media, and surface phenotype analysis by flow cytometry. Estrogen receptor α expression in W5C5(+) cells was examined using dual colour immunofluorescence. Vascularity was analysed using CD34 and alpha smooth muscle actin immunostaining and subsequent image analysis. MAIN RESULTS AND THE ROLE OF CHANCE A small population of stromal cells with MSC properties was purified with the W5C5 antibody from post-menopausal endometrium, whether atrophic from low circulating estrogen or regenerated from systemic estrogen treatment, similar to premenopausal endometrium. The MSC derived from post-menopausal endometrium treated with or without E2 fulfilled the minimum MSC criteria: clonogenicity, surface phenotype (CD29(+), CD44(+), CD73(+), CD105(+), CD140b(+), CD146(+)) and multipotency. The post-menopausal endometrial MSCs also showed comparable properties to premenopausal eMSC with respect to self-renewal in vitro and W5C5 expression. The W5C5(+) cells were located perivascularly as expected and did not express estrogen receptor α. LIMITATIONS, REASONS FOR CAUTION The properties of the MSC derived from post-menopausal endometrium were evaluated in vitro and their in vivo tissue reconstitution capacity has not been established as it has for premenopausal endometrial MSC. WIDER IMPLICATIONS OF THE FINDINGS The endometrium is an accessible source of MSC obtainable with minimum morbidity that could be used for future clinical applications as a cell-based therapy. This study shows that menopausal women can access their endometrial MSC by a simple biopsy for use in autologous therapies, particularly if their endometrium has been regenerated by short-term E2 treatment, provided they have an intact uterus and are not contraindicated for short-term E2 treatment. Endometrial MSC in post-menopausal women possess key MSC properties and are a promising source of MSC independent of a woman's age. STUDY FUNDING/COMPETING INTERESTS This study was supported by the National Health and Medical Research Council (NHMRC) of Australia grant (1021126) (C.E.G., A.R.) and Senior Research Fellowship (1042298) (C.E.G.), Australian Gynaecological Endoscopic Society grant (A.R.) , Monash International Postgraduate Research Scholarship (DU), Australian Stem Cell Centre, South East Melbourne Alliance for Regenerative Therapies and Australian Stem Cell Centre top up scholarships (DU) and Victorian Government's Operational Infrastructure Support Program. Competing interests: AR receives Preceptorship fees from AMS, advisory board fees and sponsored study from Astellas, and conducts investigator led studies sponsored by AMS and Boston Scientific for other projects. TRIAL REGISTRATION NUMBER CTNRN12610000563066.
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Affiliation(s)
- D Ulrich
- The Ritchie Centre, MIMR-PHI Institute of Medical Research, 27-31 Wright Street, Clayton, VIC 3168, Australia Monash University Department of Obstetrics and Gynaecology, Monash Medical Centre, 246 Clayton Road, Clayton, VIC 3168, Australia Present address: Department of Obstetrics and Gynaecology, Medical University Graz, 8045 Graz, Austria
| | - K S Tan
- The Ritchie Centre, MIMR-PHI Institute of Medical Research, 27-31 Wright Street, Clayton, VIC 3168, Australia
| | - J Deane
- The Ritchie Centre, MIMR-PHI Institute of Medical Research, 27-31 Wright Street, Clayton, VIC 3168, Australia
| | - K Schwab
- The Ritchie Centre, MIMR-PHI Institute of Medical Research, 27-31 Wright Street, Clayton, VIC 3168, Australia
| | - A Cheong
- The Ritchie Centre, MIMR-PHI Institute of Medical Research, 27-31 Wright Street, Clayton, VIC 3168, Australia
| | - A Rosamilia
- The Ritchie Centre, MIMR-PHI Institute of Medical Research, 27-31 Wright Street, Clayton, VIC 3168, Australia Monash University Department of Obstetrics and Gynaecology, Monash Medical Centre, 246 Clayton Road, Clayton, VIC 3168, Australia
| | - C E Gargett
- The Ritchie Centre, MIMR-PHI Institute of Medical Research, 27-31 Wright Street, Clayton, VIC 3168, Australia Monash University Department of Obstetrics and Gynaecology, Monash Medical Centre, 246 Clayton Road, Clayton, VIC 3168, Australia
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Ulrich D, Tan KS, Schwab K, Cheong A, Rosamilia A, Gargett CE. Characterisation of mesenchymal stromal cells in the postmenopausal endometrium. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1374752] [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: 10/25/2022] Open
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Schwab K, Worthington T. A novel technique for manipulation of the gallbladder with an impacted stone in Hartmann's pouch during laparoscopic cholecystectomy. Ann R Coll Surg Engl 2014; 96:163-4. [PMID: 24780680 DOI: 10.1308/rcsann.2014.96.2.163] [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: 11/22/2022] Open
Affiliation(s)
- K Schwab
- Royal Surrey County Hospital NHS Foundation Trust, UK
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Bonc-Brujevic T, Schwab K, Wyler C. Deutschunterricht für hospitalisierte Schwangere. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361448] [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: 10/26/2022]
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Parke E, Hart J, Baldock D, Barchard K, Etcoff L, Allen D, Stolberg P, Nardi N, Cohen J, Jones W, Loe S, Etcoff L, Delgaty L, Tan A, Bunner M, Delgaty L, Tan A, Bunner M, Tan A, Delgaty L, Bunner M, Tan A, Delgaty L, Bunner M, Goodman G, Kim W, Nolty A, Marion S, Davis A, Finch W, Piehl J, Moss L, Nogin R, Dean R, Davis J, Lindstrom W, Poon M, Fonseca F, Bure-Reyes A, Stewart J, Golden C, Fonseca F, Bure-Reyes A, Stewart J, Golden C, Fields K, Hill B, Corley E, Russ K, Boettcher A, Musso M, Rohling M, Rowden A, Downing K, Benners M, Miller D, Maricle D, Dugbartey T, Anum A, Anderson J, Daniel M, Hoskins L, Gillis K, Khen S, Carter K, Ayers C, Neeland I, Cullum M, Weiner M, Rossetti H, Buddin W, Mahal S, Schroeder R, Baade L, Macaluso M, Phelps K, Evans C, Clark J, Vickery C, Chow J, Stokic D, Phelps K, Evans C, Watson S, Odom R, Clark J, Clark J, Odom R, Evans C, Vickery C, Thompson J, Noggle C, Kane C, Kecala N, Lane E, Raymond M, Woods S, Iudicello J, Dawson M, Ghias A, Choe M, Yudovin S, McArthur D, Asarnow R, Giza C, Babikian T, Tun S, O'Neil M, Ensley M, Storzbach D, Ellis R, O'Neil M, Carlson K, Storzbach D, Brenner L, Freeman M, Quinones A, Motu'apuaka M, Ensley M, Kansagara D, Brickell T, Grant I, Lange R, Kennedy J, Ivins B, Marshall K, Prokhorenko O, French L, Brickell T, Lange R, Bhagwat A, French L, Weber E, Nemeth D, Songy C, Gremillion A, Lange R, Brubacher J, Shewchuk J, Heran M, Jarrett M, Rauscher A, Iverson G, Woods S, Ukueberuwa D, Medaglia J, Hillary F, Meyer J, Vargas G, Rabinowitz A, Barwick F, Arnett P, Levan A, Gale S, Atkinson J, Boettcher A, Hill B, Rohling M, Stolberg P, Hart J, Allen D, Mayfield J, Ellis M, Marion SD, Houshyarnejad A, Grant I, Akarakian R, Kernan C, Babikian T, Asarnow R, Bens M, Fisher M, Garrett C, Vinogradov S, Walker K, Torstrick A, Uderman J, Wellington R, Zhao L, Fromm N, Dahdah M, Salisbury D, Monden K, Lande E, Wanlass R, Fong G, Smith K, Miele A, Novakovic-Agopian T, Chen A, Rome S, Rossi A, Abrams G, Murphy M, Binder D, Muir J, Carlin G, Loya F, Rabinovitz B, Bruhns M, Adler M, Schleicher-Dilks S, Messerly J, Babika C, Ukpabi C, Golden C, Schleicher-Dilks S, Coad S, Messerly J, Schaffer S, Babika C, Golden C, Cowad S, Paisley S, Fontanetta R, Messerly J, Golden C, Holder C, Kloezeman K, Henry B, Burns W, Patt V, Minassian A, Perry W, Cooper L, Allen D, Vogel S, Woolery H, Ciobanu C, Simone A, Bedard A, Olivier T, O'Neill S, Rajendran K, Halperin J, Rudd-Barnard A, Steenari M, Murry J, Le M, Becker T, Mucci G, Zupanc M, Shapiro E, Santos O, Cadavid N, Giese E, Londono N, Osmon D, Zamzow J, Culnan E, D'Argenio D, Mosti C, Spiers M, Schleicher-Dilks S, Kloss J, Curiel A, Miller K, Olmstead R, Gottuso A, Saucier C, Miller J, Dye R, Small G, Kent A, Andrews P, Puente N, Terry D, Faraco C, Brown C, Patel A, Siegel J, Miller L, Lee B, Joan M, Thaler N, Fontanetta R, Carla F, Allen D, Nguyen T, Glass L, Coles C, Julie K, May P, Sowell E, Jones K, Riley E, Demsky Y, Mattson S, Allart A, Freer B, Tiersky L, Sunderaraman P, Sylvester P, Ang J, Schultheis M, Newton S, Holland A, Burns K, Bunting J, Taylor J, Muetze H, Coe M, Harrison D, Putnam M, Tiersky L, Freer B, Holland A, Newton S, Sakamoto M, Bunting J, Taylor J, Coe M, Harrison D, Musso M, Hill B, Barker A, Pella R, Gouvier W, Davis J, Woods S, Wall J, Etherton J, Brand T, Hummer B, O'Shea C, Segovia J, Thomlinson S, Schulze E, Roskos P, Gfeller J, Loftis J, Fogel T, Barrera K, Sherzai A, Chappell A, Harrison A, Armstrong I, Flaro L, Pedersen H, Shultz LS, Roper B, Huckans M, Basso M, Silk-Eglit G, Stenclik J, Miele A, Lynch J, McCaffrey R, Silk-Eglit G, Stenclik J, Miele A, Lynch J, Musso M, McCaffrey R, Martin P, VonDran E, Baade L, Heinrichs R, Schroeder R, Hunter B, Calloway J, Rolin S, Akeson S, Westervelt H, Mohammed S, An K, Jeffay E, Zakzanis K, Lynch A, Drasnin D, Ikanga J, Graham O, Reid M, Cooper D, Long J, Lange R, Kennedy J, Hopewell C, Lukaszewska B, Pachalska M, Bidzan M, Lipowska M, McCutcheon L, Kaup A, Park J, Morgan E, Kenton J, Norman M, Martin P, Netson K, Woods S, Smith M, Paulsen J, Hahn-Ketter A, Paxton J, Fink J, Kelley K, Lee R, Pliskin N, Segala L, Vasilev G, Bozgunov K, Naslednikova R, Raynov I, Gonzalez R, Vassileva J, Bonilla X, Fedio A, Johnson K, Sexton J, Blackstone K, Weber E, Moore D, Grant I, Woods S, Pimental P, Welch M, Ring M, Stranks E, Crowe S, Jaehnert S, Ellis C, Prince C, Wheaton V, Schwartz D, Loftis J, Fuller B, Hoffman W, Huckans M, Turecka S, McKeever J, Morse C, Schultheis M, Dinishak D, Dasher N, Vik P, Hachey D, Bowman B, Van Ness E, Williams C, Zamzow J, Sunderaraman P, Kloss J, Spiers M, Swirsky-Sacchetti T, Alhassoon O, Taylor M, Sorg S, Schweinsburg B, Stricker N, Kimmel C, Grant I, Alhassoon O, Taylor M, Sorg S, Schweinsburg B, Stephan R, Stricker N, Grant I, Hertza J, Tyson K, Northington S, Loughan A, Perna R, Davis A, Collier M, Schroeder R, Buddin W, Schroeder R, Moore C, Andrew W, Ghelani A, Kim J, Curri M, Patel S, Denney D, Taylor S, Huberman S, Greenberg B, Lacritz L, Brown D, Hughes S, Greenberg B, Lacritz L, Vargas V, Upshaw N, Whigham K, Peery S, Casto B, Barker L, Otero T, La D, Nunan-Saah J, Phoong M, Gill S, Melville T, Harley A, Gomez R, Adler M, Tsou J, Schleicher-Dilks S, Golden C, Tsou J, Schleicher-Dilks S, Adler M, Golden C, Cowad S, Link J, Barker T, Gulliver K, Golden C, Young K, Moses J, Lum J, Vik P, Legarreta M, Van Ness E, Williams C, Dasher N, Williams C, Vik P, Dasher N, Van Ness E, Bowman B, Nakhutina L, Margolis S, Baek R, Gonzalez J, Hill F, England H, Horne-Moyer L, Stringer A, DeFilippis N, Lyon A, Giovannetti T, Fanning M, Heverly-Fitt S, Stambrook E, Price C, Selnes O, Floyd T, Vogt E, Thiruselvam I, Quasney E, Hoelzle J, Grant N, Moses J, Matevosyan A, Delano-Wood L, Alhassoon O, Hanson K, Lanni E, Luc N, Kim R, Schiehser D, Benners M, Downing K, Rowden A, Miller D, Maricle D, Kaminetskaya M, Moses J, Tai C, Kaminetskaya M, Melville T, Poole J, Scott R, Hays F, Walsh B, Mihailescu C, Douangratdy M, Scott B, Draffkorn C, Andrews P, Schmitt A, Waksmunski C, Brady K, Andrews A, Golden C, Olivier T, Espinoza K, Sterk V, Spengler K, Golden C, Olivier T, Spengler K, Sterk V, Espinoza K, Golden C, Gross J, DeFilippis N, Neiman-Kimel J, Romers C, Isaacs C, Soper H, Sordahl J, Tai C, Moses J, D'Orio V, Glukhovsky L, Beier M, Shuman M, Spat J, Foley F, Guatney L, Bott N, Moses J, Miranda C, Renteria MA, Rosario A, Sheynin J, Fuentes A, Byrd D, Mindt MR, Batchelor E, Meyers J, Patt V, Thomas M, Minassian A, Geyer M, Brown G, Perry W, Smith C, Kiefel J, Rooney A, Gouaux B, Ellis R, Grant I, Moore D, Graefe A, Wyman-Chick K, Daniel M, Beene K, Jaehnert S, Choi A, Moses J, Iudicello J, Henry B, Minassian A, Perry W, Marquine M, Morgan E, Letendre S, Ellis R, Woods S, Grant I, Heaton R, Constantine K, Fine J, Palewjala M, Macher R, Guatney L, Earleywine M, Draffkorn C, Scott B, Andrews P, Schmitt A, Dudley M, Silk-Eglit G, Stenclik J, Miele A, Lynch J, McCaffrey R, Scharaga E, Gomes W, McGinley J, Miles-Mason E, Colvin M, Carrion L, Romers C, Soper H, Zec R, Kohlrus S, Fritz S, Robbs R, Ala T, Zec R, Fritz S, Kohlrus S, Robbs R, Ala T, Edwards M, Hall J, O'Bryant S, Miller J, Dye R, Miller K, Baerresen K, Small G, Moskowitz J, Puente A, Ahmed F, Faraco C, Brown C, Evans S, Chu K, Miller L, Young-Bernier M, Tanguay A, Tremblay F, Davidson P, Duda B, Puente A, Terry D, Kent A, Patel A, Miller L, Junod A, Marion SD, Harrington M, Fonteh A, Gurnani A, John S, Gavett B, Diaz-Santos M, Mauro S, Beaute J, Cronin-Golomb A, Fazeli P, Gouaux B, Rosario D, Heaton R, Moore D, Puente A, Lindbergh C, Chu K, Evans S, Terry D, Duda B, Mackillop J, Miller S, Greco S, Klimik L, Cohen J, Robbins J, Lashley L, Schleicher-Dilks S, Golden C, Kunkes I, Culotta V, Kunkes I, Griffits K, Loughan A, Perna R, Hertza J, Cohen M, Northington S, Tyson K, Musielak K, Fine J, Kaczorowski J, Doty N, Braaten E, Shah S, Nemanim N, Singer E, Hinkin C, Levine A, Gold A, Evankovich K, Lotze T, Yoshida H, O'Bryan S, Roberg B, Glusman M, Ness A, Thelen J, Wilson L, Feaster T, Bruce J, Lobue C, Brown D, Hughes S, Greenberg B, Lacritz L, Bristow-Murray B, Andrews A, Bermudez C, Golden C, Moore R, Pulver A, Patterson T, Bowie C, Harvey P, Jeste D, Mausbach B, Wingo J, Fink J, Lee R, Pliskin N, Legenkaya A, Henry B, Minassian A, Perry W, McKeever J, Morse C, Thomas F, Schultheis M, Ruocco A, Daros A, Gill S, Grimm D, Saini G, Relova R, Hoblyn J, Lee T, Stasio C, Mahncke H, Drag L, Grimm D, Gill S, Saini G, Relova R, Hoblyn J, Lee T, Stasio C, Mahncke H, Drag L, Verbiest R, Ringdahl E, Thaler N, Sutton G, Vogel S, Reyes A, Ringdahl E, Vogel S, Freeman A, Call E, Allen D, March E, Salzberg M, Vogel S, Ringdahl E, Freeman A, Dadis F, Allen D, Sisk S, Ringdahl E, Vogel S, Freeman A, Allen D, DiGangi J, Silva L, Pliskin N, Thieme B, Daniel M, Jaehnert S, Noggle C, Thompson J, Kecala N, Lane E, Kane C, Noggle C, Thompson J, Lane E, Kecala N, Kane C, Palmer G, Happe M, Paxson J, Jurek B, Graca J, Olson S, Melville T, Harley A, La D, Phoong M, Gill S, Jocson VA, Nunan-Saah J, Keller J, Gomez R, Melville T, Kaminetskaya M, Poole J, Vernon A, Van Vleet T, DeGutis J, Chen A, Marini C, Dabit S, Gallegos J, Zomet A, Merzenich M, Thaler N, Linck J, Heyanka D, Pastorek N, Miller B, Romesser J, Sim A, Allen D, Zimmer A, Marcinak J, Hibyan S, Webbe F, Rainwater B, Francis J, Baum L, Sautter S, Donders J, Hui E, Barnes K, Walls G, Erikson S, Bailie J, Schwab K, Ivins B, Boyd C, Neff J, Cole W, Lewis S, Bailie J, Schwab K, Ivins B, Boyd C, Neff J, Cole W, Lewis S, Ramirez C, Oganes M, Gold S, Tanner S, Pina D, Merritt V, Arnett P, Heyanka D, Linck J, Thaler N, Pastorek N, Miller B, Romesser J, Sim A, Parks A, Roskos P, Gfeller J, Clark A, Isham K, Carter J, McLeod J, Romero R, Dahdah M, Barisa M, Schmidt K, Barnes S, Dubiel R, Dunklin C, Harper C, Callender L, Wilson A, Diaz-Arrastia R, Shafi S, Jacquin K, Bolshin L, Jacquin K, Romers C, Gutierrez E, Messerly J, Tsou J, Adler M, Golden C, Harmell A, Mausbach B, Moore R, Depp C, Jeste D, Palmer B, Hoadley R, Hill B, Rohling M, Mahdavi S, Fine J, daCruz K, Dinishak D, Richardson G, Vertinski M, Allen D, Mayfield J, Margolis S, Miele A, Rabinovitz B, Schaffer S, Kline J, Boettcher A, Hill B, Hoadley R, Rohling M, Eichstaedt K, Vale F, Benbadis S, Bozorg A, Rodgers-Neame N, Rinehardt E, Mattingly M, Schoenberg M, Fares R, Fares R, Carrasco R, Grups J, Evans B, Simco E, Mittenberg W, Carrasco R, Grups J, Evans B, Simco E, Mittenberg W, Rach A, Baughman B, Young C, Bene E, Irwin C, Li Y, Poulin R, Jerram M, Susmaras T, Gansler D, Ashendorf L, Miarmi L, Fazio R, Cantor J, Fernandez A, Godoy-Garcete G, Marchetti P, Harrison A, Armstrong I, Harrison L, Iverson G, Brinckman D, Ayaz H, Schultheis M, Heinly M, Vitelli K, Russler K, Sanchez I, Jones W, Loe S, Raines T, Hart J, Bene E, Li Y, Irwin C, Baughman B, Rach A, Bravo J, Schilling B, Weiss L, Lange R, Shewchuk J, Heran M, Rauscher A, Jarrett M, Brubacher J, Iverson G, Zink D, Barney S, Gilbert G, Allen D, Martin P, Schroeder R, Klas P, Jeffay E, Zakzanis K, Iverson G, Lanting S, Saffer B, Koehle M, Palmer B, Barrio C, Vergara R, Muniz M, Pinto L, Jeste D, Stenclik J, Lynch J, McCaffrey R, Shultz LS, Pedersen H, Roper B, Crouse E, Crucian G, Dezhkam N, Mulligan K, Singer R, Psihogios A, Davis A, Stephens B, Love C, Mulligan K, Webbe F, West S, McCue R, Goldin Y, Cicerone K, Ruchinskas R, Seidl JT, Massman P, Tam J, Schmitter-Edgecombe M, Baerresen K, Hanson E, Miller K, Miller J, Yeh D, Kim J, Ercoli L, Siddarth P, Small G, Noback M, Noback M, Baldock D, Mahmoud S, Munic-Miller D, Bonner-Jackson A, Banks S, Rabin L, Emerson J, Smith C, Roberts R, Hass S, Duhig A, Pankratz V, Petersen R, Leibson C, Harley A, Melville T, Phoong M, Gill S, Nunan-Saah J, La D, Gomez R, Lindbergh C, Puente A, Gray J, Chu K, Evans S, Sweet L, MacKillop J, Miller L, McAlister C, Schmitter-Edgecombe M, Baldassarre M, Kamm J, Wolff D, Dombrowski C, Bullard S, Edwards M, Hall J, Parsons T, O'Bryant S, Lawson R, Papadakis A, Higginson C, Barnett J, Wills M, Strang J, Dominska A, Wallace G, Kenworthy L, Bott N, Kletter H, Carrion V, Ward C, Getz G, Peer J, Baum C, Edner B, Mannarino A, Casnar C, Janke K, van der Fluit F, Natalie B, Haberman D, Solomon M, Hunter S, Klein-Tasman B, Starza-Smith A, Talbot E, Hart A, Hall M, Baker J, Kral M, Lally M, Zisk A, Lo T, Ross P, Cuevas M, Patel S, Lebby P, Mouanoutoua A, Harrison J, Pollock M, Mathiowetz C, Romero R, Boys C, Vekaria P, Vasserman M, MacAllister W, Stevens S, Van Hecke A, Carson A, Karst J, Schohl K, Dolan B, McKindles R, Remel R, Reveles A, Fritz N, McDonald G, Wasisco J, Kahne J, Hertza J, Tyson K, Northington S, Loughan A, Perna R, Newman A, Garmoe W, Clark J, Loughan A, Perna R, Hertza J, Cohen M, Northington S, Tyson K, Whithers K, Puente A, Dedmon A, Capps J, Lindsey H, Francis M, Weigand L, Steed A, Puente A, Edmed S, Sullivan K, Puente A, Lindsey H, Dedmon A, Capps J, Whithers K, Weigand L, Steed A, Kark S, Lafleche G, Brown T, Bogdanova Y, Strongin E, Spickler C, Drasnin D, Strongin C, Poreh A, Houshyarnejad A, Ellis M, Babikian T, Kernan C, Asarnow R, Didehbani N, Cullum M, Loneman L, Mansinghani S, Hart J, Fischer J. POSTER SESSIONS SCHEDULE. Arch Clin Neuropsychol 2013. [DOI: 10.1093/arclin/act054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Goldstein JN, Brouwers HB, Romero JM, McNamara K, Schwab K, Greenberg SM, Rosand J. SCORE-IT: the Spot Sign score in restricting ICH growth─an Atach-II ancillary study. J Vasc Interv Neurol 2012; 5:20-5. [PMID: 23230461 PMCID: PMC3517028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION The ATACH-II trial is designed to evaluate whether intensive blood pressure reduction can reduce hematoma growth and improve outcome. However, it is difficult to determine, at presentation, which patients are at highest risk of ongoing bleeding, and will receive the most clinical benefit from blood pressure therapy. It may be that improved predictive markers will lead to efficient, personalized selection of optimal therapy. We hypothesize that specific imaging findings on CT angiography (CTA) and MRI will mark those patients who receive the most benefit from intensive blood pressure reduction. METHODS Many patients enrolled in ATACH-II will undergo CTA and/or MRI as part of routine clinical care. We will perform a blinded analysis of these images. For CTA, we will determine the presence of contrast pooling (also termed contrast extravasation or the "Spot Sign"). In addition, we will calculate a Spot Sign Score, a score that includes number of Spot Signs, diameter, and contrast density. For MRI, we will focus on the presence, number, and location of cerebral microbleeds (CMBs) on sensitive T2*-weighted MRI sequences. RESULTS We will test the hypothesis that patients with a Spot Sign will receive clinical benefit from intensive blood pressure reduction. In addition, we will determine whether patients with the highest Spot Sign Scores receive the most benefit from intensive blood pressure reduction. Finally, we will determine whether the absence of CMBs marks those at higher risk for hematoma expansion, and therefore more likely to benefit from treatment. CONCLUSION This ancillary study offers the tremendous opportunity to determine whether imaging findings can risk stratify ICH patients for acute therapies aimed at limiting hematoma growth.
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Affiliation(s)
- JN Goldstein
- Hemorrhagic Stroke Research Group, Massachusetts General Hospital, Boston, MA, USA
- Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Department of Emergency Medicine, Massachusetts General Hospital, Zero Emerson Place, Suite 3B, Boston, MA 02114, USA
| | - HB Brouwers
- Hemorrhagic Stroke Research Group, Massachusetts General Hospital, Boston, MA, USA
- Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA
| | - JM Romero
- Department of Emergency Medicine, Massachusetts General Hospital, Zero Emerson Place, Suite 3B, Boston, MA 02114, USA
| | - K McNamara
- Hemorrhagic Stroke Research Group, Massachusetts General Hospital, Boston, MA, USA
| | - K Schwab
- Hemorrhagic Stroke Research Group, Massachusetts General Hospital, Boston, MA, USA
| | - SM Greenberg
- Hemorrhagic Stroke Research Group, Massachusetts General Hospital, Boston, MA, USA
- Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - J Rosand
- Hemorrhagic Stroke Research Group, Massachusetts General Hospital, Boston, MA, USA
- Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA
- Neuroradiology Service, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
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Auriel E, Gurol E, Ayers A, Schwab K, Vashkevich A, Rosand J, Viswanathan A, Greenberg S. Ongoing Microinfarction in Patients with Intracerebral Hemorrhage (S23.002). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s23.002] [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: 11/15/2022] Open
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Biffi A, Shulman JM, Jagiella JM, Cortellini L, Ayres AM, Schwab K, Brown DL, Silliman SL, Selim M, Worrall BB, Meschia JF, Slowik A, De Jager PL, Greenberg SM, Schneider JA, Bennett DA, Rosand J. Genetic variation at CR1 increases risk of cerebral amyloid angiopathy. Neurology 2012; 78:334-41. [PMID: 22262751 DOI: 10.1212/wnl.0b013e3182452b40] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Accumulated evidence suggests that a variant within the CR1 gene (single nucleotide polymorphism rs6656401), known to increase risk for Alzheimer disease (AD), influences β-amyloid (Aβ) deposition in brain tissue. Given the biologic overlap between AD and cerebral amyloid angiopathy (CAA), a leading cause of intracerebral hemorrhage (ICH) in elderly individuals, we investigated whether rs6656401 increases the risk of CAA-related ICH and influences vascular Aβ deposition. METHODS We performed a case-control genetic association study of 89 individuals with CAA-related ICH and 280 individuals with ICH unrelated to CAA and compared them with 324 ICH-free control subjects. We also investigated the effect of rs6656401 on risk of recurrent CAA-ICH in a prospective longitudinal cohort of ICH survivors. Finally, association with severity of histopathologic CAA was investigated in 544 autopsy specimens from 2 longitudinal studies of aging. RESULTS rs6656401 was associated with CAA-ICH (odds ratio [OR] = 1.61, 95% confidence interval [CI] 1.19-2.17, p = 8.0 × 10(-4)) as well as with risk of recurrent CAA-ICH (hazard ratio = 1.35, 95% CI 1.04-1.76, p = 0.024). Genotype at rs6656401 was also associated with severity of CAA pathology at autopsy (OR = 1.34, 95% CI 1.05-1.71, p = 0.009). Adjustment for parenchymal amyloid burden did not cancel this effect, suggesting that, despite the correlation between parenchymal and vascular amyloid pathology, CR1 acts independently on both processes, thus increasing risk of both AD and CAA. CONCLUSION The CR1 variant rs6656401 influences risk and recurrence of CAA-ICH, as well as the severity of vascular amyloid deposition.
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Affiliation(s)
- A Biffi
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA
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Biffi A, Battey TWK, Ayres AM, Cortellini L, Schwab K, Gilson AJ, Rost NS, Viswanathan A, Goldstein JN, Greenberg SM, Rosand J. Warfarin-related intraventricular hemorrhage: imaging and outcome. Neurology 2011; 77:1840-6. [PMID: 22049204 DOI: 10.1212/wnl.0b013e3182377e12] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Oral anticoagulation therapy (OAT) with warfarin increases mortality and disability after intracerebral hemorrhage (ICH), the result of increased ICH volume and risk of hematoma expansion. We investigated whether OAT also influences risk of development of intraventricular hemorrhage (IVH), the volume of IVH and IVH expansion, and whether IVH is a substantive mediator of the overall effect of OAT on ICH outcome. METHODS We performed a retrospective analysis of a prospectively collected single-center cohort of 1,879 consecutive ICH cases (796 lobar, 865 deep, 153 cerebellar, 15 multiple location, 50 primary IVH) from 1999 to 2009. ICH and IVH volumes at presentation, as well as hematoma expansion (>33% or >6 mL increase) and IVH expansion (>2 mL increase), were determined using established semiautomated methods. Outcome was assessed at 90 days using either the modified Rankin Scale or Glasgow Outcome Scale. RESULTS Warfarin use was associated with IVH risk, IVH volume at presentation, and IVH expansion in both lobar and deep ICH (all p < 0.05) in a dose-response relationship with international normalized ratio. Warfarin was associated with poor outcome in both lobar and deep ICH (p < 0.01), and >95% of this effect was accounted for by baseline ICH and IVH volumes, as well as ICH and IVH expansion. CONCLUSION Warfarin increases IVH volume and risk of IVH expansion in lobar and deep ICH. These findings (along with effects on ICH volume and expansion) likely represent the mechanisms by which anticoagulation worsens ICH functional outcome.
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Affiliation(s)
- A Biffi
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA
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Eilers E, Kilavuz O, Henning D, Schwab K, Lenz F, Rossi R. Pränatale Gastroschisis- postnatal: konnatales Kurzdarmsyndrom. Z Geburtshilfe Neonatol 2011. [DOI: 10.1055/s-0031-1293361] [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: 10/15/2022]
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Milde T, Schwab K, Walther M, Eiselt M, Schelenz C, Voss A, Witte H. Time-variant partial directed coherence in analysis of the cardiovascular system. A methodological study. Physiol Meas 2011; 32:1787-805. [PMID: 22027489 DOI: 10.1088/0967-3334/32/11/s06] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Time-variant partial directed coherence (tvPDC) is used for the first time in a multivariate analysis of heart rate variability (HRV), respiratory movements (RMs) and (systolic) arterial blood pressure. It is shown that respiration-related HRV components which also occur at other frequencies besides the RM frequency (= respiratory sinus arrhythmia, RSA) can be identified. These additional components are known to be an effect of the 'half-the-mean-heart-rate-dilemma' ('cardiac aliasing' CA). These CA components may contaminate the entire frequency range of HRV and can lead to misinterpretation of the RSA analysis. TvPDC analysis of simulated and clinical data (full-term neonates and sedated patients) reveals these contamination effects and, in addition, the respiration-related CA components can be separated from the RSA component and the Traube-Hering-Mayer wave. It can be concluded that tvPDC can be beneficially applied to avoid misinterpretations in HRV analyses as well as to quantify partial correlative interaction properties between RM and RSA.
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Affiliation(s)
- T Milde
- Bernstein Group for Computational Neuroscience Jena, Institute of Medical Statistics, Computer Sciences and Documentation, Jena, Germany.
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Fallows R, McCoy K, Hertza J, Klosson E, Estes B, Stroescu I, Salinas C, Stringer A, Aronson S, MacAllister W, Spurgin A, Morriss M, Glasier P, Stavinoha P, Houshyarnejad A, Jacobus J, Norman M, Peery S, Mattingly M, Pennuto T, Anderson-Hanley C, Miele A, Dunnam M, Edwards M, O'Bryant S, Johnson L, Barber R, Inscore A, Kegel J, Kozlovsky A, Tarantino B, Goldberg A, Herrera-Pino J, Jubiz-Bassi N, Rashid K, Noniyeva Y, Vo K, Stephens V, Gomez R, Sanders C, Kovacs M, Walton B, Schmitter-Edgecombe M, Schmitter-Edgecombe M, Parsey C, Cook D, Woods S, Weinborn M, Velnoweth A, Rooney A, Bucks R, Adalio C, White S, Blair J, Barber B, Marcy S, Barber B, Marcy S, Boseck J, McCormick C, Davis A, Berry K, Koehn E, Tiberi N, Gelder B, Brooks B, Sherman E, Garcia M, Robillard R, Gunner J, Miele A, Lynch J, McCaffrey R, Hamilton J, Froming K, Nemeth D, Steger A, Lebby P, Harrison J, Mounoutoua A, Preiss J, Brimager A, Gates E, Chang J, Cisneros H, Long J, Petrauskas V, Casey J, Picard E, Long J, Petrauskas V, Casey J, Picard E, Miele A, Gunner J, Lynch J, McCaffrey R, Rodriguez M, Fonseca F, Golden C, Davis J, Wall J, DeRight J, Jorgensen R, Lewandowski L, Ortigue S, Etherton J, Axelrod B, Green C, Snead H, Semrud-Clikeman M, Kirk J, Connery A, Kirkwood M, Hanson ML, Fazio R, Denney R, Myers W, McGuire A, Tree H, Waldron-Perrine B, Goldenring Fine J, Spencer R, Pangilinan P, Bieliauskas L, Na S, Waldron-Perrine B, Tree H, Spencer R, Pangilinan P, Bieliauskas L, Peck C, Bledsoe J, Schroeder R, Boatwright B, Heinrichs R, Baade L, Rohling M, Hill B, Ploetz D, Womble M, Shenesey J, Schroeder R, Semrud-Clikeman M, Baade L, VonDran E, Webster B, Brockman C, Burgess A, Heinrichs R, Schroeder R, Baade L, VonDran E, Webster B, Goldenring Fine J, Brockman C, Heinrichs R, Schroeder R, Baade L, VonDran E, Webster B, Brockman C, Heinrichs R, Schroeder R, Baade L, Bledsoe J, VonDran E, Webster B, Brockman C, Heinrichs R, Schroeder R, Baade L, VonDran E, Webster B, Brockman C, Heinrichs R, Thaler N, Strauss G, White T, Gold J, Tree H, Waldron-Perrine B, Spencer R, McGuire A, Na S, Pangilinan P, Bieliauskas L, Allen D, Vincent A, Roebuck-Spencer T, Cooper D, Bowles A, Gilliland K, Watts A, Ahmed F, Miller L, Yon A, Gordon B, Bello D, Bennett T, Yon A, Gordon B, Bennett T, Wood N, Etcoff L, Thede L, Oraker J, Gibson F, Stanford L, Gray S, Vroman L, Semrud-Clikeman M, Taylor T, Seydel K, Bure-Reyes A, Stewart J, Tourgeman I, Demsky Y, Golden C, Burns W, Gray S, Burns K, Calderon C, Tourgeman I, Golden C, Neblina C, San Miguel Montes L, Allen D, Strutt A, Scott B, Strutt A, Scott B, Armstrong P, Booth C, Blackstone K, Moore D, Gouaux B, Ellis R, Atkinson J, Grant I, Brennan L, Schultheis M, Hurtig H, Weintraub D, Duda J, Moberg P, Chute D, Siderowf A, Brescian N, Gass C, Brewster R, King T, Morris R, Krawiecki N, Dinishak D, Richardson G, Estes B, Knight M, Hertza J, Fallows R, McCoy K, Garcia S, Strain G, Devlin M, Cohen R, Paul R, Crosby R, Mitchell J, Gunstad J, Hancock L, Bruce J, Roberg B, Lynch S, Hertza J, Klosson E, Varnadore E, Schiff W, Estes B, Hertza J, Varnadore E, Estes B, Kaufman R, Rinehardt E, Schoenberg M, Mattingly M, Rosado Y, Velamuri S, LeBlanc M, Pimental P, Lynch-Chee S, Broshek D, Lyons P, McKeever J, Morse C, Ang J, Leist T, Tracy J, Schultheis M, Morgan E, Woods S, Rooney A, Perry W, Grant I, Letendre S, Morse C, McKeever J, Schultheis M, Musso M, Jones G, Hill B, Proto D, Barker A, Gouvier W, Nersesova K, Drexler M, Cherkasova E, Sakamoto M, Marcotte T, Hilsabeck R, Perry W, Carlson M, Barakat F, Hassanein T, Shevchik K, McCaw W, Schrock B, Smith M, Moser D, Mills J, Epping E, Paulsen J, Somogie M, Bruce J, Bryan F, Buscher L, Tyrer J, Stabler A, Thelen J, Lovelace C, Spurgin A, Graves D, Greenberg B, Harder L, Szczebak M, Glisky M, Thelen J, Lynch S, Hancock L, Bruce J, Ukueberuwa D, Arnett P, Vahter L, Ennok M, Pall K, Gross-Paju K, Vargas G, Medaglia J, Chiaravalloti N, Zakrzewski C, Hillary F, Andrews A, Golden C, Belloni K, Nicewander J, Miller D, Johnson S, David Z, Weideman E, Lawson D, Currier E, Morton J, Robinson J, Musso M, Hill B, Barker A, Pella R, Jones G, Proto D, Gouvier W, Vertinski M, Allen D, Thaler N, Heisler D, Park B, Barney S, Kucukboyaci N, Girard H, Kemmotsu N, Cheng C, Kuperman J, McDonald C, Carroll C, Odland A, Miller L, Mittenberg W, Coalson D, Wahlstrom D, Raiford S, Holdnack J, Ennok M, Vahter L, Gardner E, Dasher N, Fowler B, Vik P, Grajewski M, Lamar M, Penney D, Davis R, Korthauer L, Libon D, Kumar A, Holdnack J, Iverson G, Chelune G, Hunter C, Zimmerman E, Klein R, Prathiba N, Hopewell A, Cooper D, Kennedy J, Long M, Moses J, Lutz J, Tiberi N, Dean R, Miller J, Axelrod B, Van Dyke S, Rapport L, Schutte C, Hanks R, Pella R, Fallows R, McCoy K, O'Rourke J, Hilsabeck R, Petrauskas V, Bowden S, Romero R, Hulkonen R, Boivin M, Bangirana P, John C, Shapiro E, Slonaker A, Pass L, Smigielski J, Biernacka J, Geske J, Hall-Flavin D, Loukianova L, Schneekloth T, Abulseoud O, Mrazek D, Karpyak V, Terranova J, Safko E, Heisler D, Thaler N, Allen D, Van Dyke S, Axelrod B, Zink D, Puente A, Ames H, LePage J, Carroll C, Knee K, Mittenberg W, Cummings T, Webbe F, Shepherd E, Marcinak J, Diaz-Santos M, Seichepine D, Sullivan K, Neargarder S, Cronin-Golomb A, Franchow E, Suchy Y, Kraybill M, Holland A, Newton S, Hinson D, Smith A, Coe M, Carmona J, Harrison D, Hyer L, Atkinson M, Dalibwala J, Yeager C, Hyer L, Scott C, Atkinson M, Yeager C, Jacobson K, Olson K, Pella R, Fallows R, McCoy K, O'Rourke J, Hilsabeck R, Rosado Y, Kaufman R, Velamuri S, Rinehardt E, Mattingly M, Sartori A, Clay O, Ovalle F, Rothman R, Crowe M, Schmid A, Horne L, Horn G, Johnson-Markve B, Gorman P, Stewart J, Bure-Reyes A, Golden C, Tam J, McAlister C, Schmitter-Edgecombe M, Wagner M, Brenner L, Walker A, Armstrong L, Inman E, Grimmett J, Gray S, Cornelius A, Hertza J, Klosson E, Varnadore E, Schiff W, Estes B, Johnson L, Willingham M, Restrepo L, Bolanos J, Patel F, Golden C, Rice J, Dougherty M, Golden C, Sharma V, Martin P, Golden C, Bradley E, Dinishak D, Lockwood C, Poole J, Brickell T, Lange R, French L, Chao L, Klein S, Dunnam M, Miele A, Warner G, Donnelly K, Donnelly J, Kittleson J, Bradshaw C, Alt M, England D, Denney R, Meyers J, Evans J, Lynch-Chee S, Kennedy C, Moore J, Fedor A, Spitznagel M, Gunstad J, Ferland M, Guerrero NK, Davidson P, Collins B, Marshall S, Herrera-Pino J, Samper G, Ibarra S, Parrott D, Steffen F, Backhaus S, Karver C, Wade S, Taylor H, Brown T, Kirkwood M, Stancin T, Krishnan K, Culver C, Arenivas A, Bosworth C, Shokri-Kojori E, Diaz-Arrastia R, Marquez de la PC, Lange R, Ivins B, Marshall K, Schwab K, Parkinson G, Iverson G, Bhagwat A, French L, Lichtenstein J, Adams-Deutsch Z, Fleischer J, Goldberg K, Lichtenstein J, Adams-Deutsch Z, Fleischer J, Goldberg K, Lichtenstein J, Fleischer J, Goldberg K, Lockwood C, Ehrler M, Hull A, Bradley E, Sullivan C, Poole J, Lockwood C, Sullivan C, Hull A, Bradley E, Ehrler M, Poole J, Marcinak J, Schuster D, Al-Khalil K, Webbe F, Myers A, Ireland S, Simco E, Carroll C, Mittenberg W, Palmer E, Poole J, Bradley E, Dinishak D, Piecora K, Marcinak J, Al-Khalil K, Mroczek N, Schuster D, Snyder A, Rabinowitz A, Arnett P, Schatz P, Cameron N, Stolberg P, Hart J, Jones W, Mayfield J, Allen D, Sullivan K, Edmed S, Vanderploeg R, Silva M, Vaughan C, McGuire E, Gerst E, Fricke S, VanMeter J, Newman J, Gioia G, Vaughan C, VanMeter J, McGuire E, Gioia G, Newman J, Gerst E, Fricke S, Wahlberg A, Zelonis S, Chatterjee A, Smith S, Whipple E, Mace L, Manning K, Ang J, Schultheis M, Wilk J, Herrell R, Hoge C, Zakzanis K, Yu S, Jeffay E, Zimmer A, Webbe F, Piecora K, Schuster D, Zimmer A, Piecora K, Schuster D, Webbe F, Adler M, Holster J, Golden C, Andrews A, Schleicher-Dilks S, Golden C, Arffa S, Thornton J, Arffa S, Thornton J, Arffa S, Thornton J, Arffa S, Thornton J, Canas A, Sevadjian C, Fournier A, Miller D, Maricle D, Donders J, Larsen T, Gidley Larson J, Sheehan J, Suchy Y, Higgins K, Rolin S, Dunham K, Akeson S, Horton A, Reynolds C, Horton A, Reynolds C, Jordan L, Gonzalez S, Heaton S, McAlister C, Tam J, Schmitter-Edgecombe M, Olivier T, West S, Golden C, Prinzi L, Martin P, Robbins J, Bruzinski B, Golden C, Riccio C, Blakely A, Yoon M, Reynolds C, Robbins J, Prinzi L, Martin P, Golden C, Schleicher-Dilks S, Andrews A, Adler M, Pearlson J, Golden C, Sevadjian C, Canas A, Fournier A, Miller D, Maricle D, Sheehan J, Gidley LJ, Suchy Y, Sherman E, Carlson H, Gaxiola-Valdez I, Wei X, Beaulieu C, Hader W, Brooks B, Kirton A, Barlow K, Hrabok M, Mohamed I, Wiebe S, Smith K, Ailion A, Ivanisevic M, King T, Smith K, King T, Thorgusen S, Bowman D, Suchy Y, Walsh K, Mitchell F, Jill G, Iris P, Ross K, Madan-Swain A, Gioia G, Isquith P, Webber D, DeFilippis N, Collins M, Hill F, Weber R, Johnson A, Wiley C, Zimmerman E, Burns T, DeFilippis N, Ritchie D, Odland A, Stevens A, Mittenberg W, Hartlage L, Williams B, Weidemann E, Demakis G, Avila J, Razani J, Burkhart S, Adams W, Edwards M, O'Bryant S, Hall J, Johnson L, Grammas P, Gong G, Hargrave K, Mattevada S, Barber R, Hall J, Vo H, Johnson L, Barber R, O'Bryant S, Hill B, Davis J, O'Connor K, Musso M, Rehm-Hamilton T, Ploetz D, Rohling M, Rodriguez M, Potter E, Loewenstein D, Duara R, Golden C, Velamuri S, Rinehardt E, Schoenberg M, Mattingly M, Kaufman R, Rosado Y, Boseck J, Tiberi N, McCormick C, Davis A, Hernandez Finch M, Gelder B, Cannon M, McGregor S, Reitman D, Rey J, Scarisbrick D, Holdnack J, Iverson G, Thaler N, Bello D, Whoolery H, Etcoff L, Vekaria P, Whittington L, Nemeth D, Gremillion A, Olivier T, Amirthavasagam S, Jeffay E, Zakzanis K, Barney S, Umuhoza D, Strauss G, Knatz-Bello D, Allen D, Bolanos J, Bell J, Restrepo L, Frisch D, Golden C, Hartlage L, Williams B, Iverson G, McIntosh D, Kjernisted K, Young A, Kiely T, Tai C, Gomez R, Schatzberg A, Keller J, Rhodes E, Ajilore O, Zhang A, Kumar A, Lamar M, Ringdahl E, Sutton G, Turner A, Snyder J, Allen D, Verbiest R, Thaler N, Strauss G, Allen D, Walkenhorst E, Crowe S, August-Fedio A, Sexton J, Cummings S, Brown K, Fedio P, Grigorovich A, Fish J, Gomez M, Leach L, Lloyd H, Nichols M, Goldberg M, Novakovic-Agopian T, Chen A, Abrams G, Rossi A, Binder D, Muir J, Carlin G, Murphy M, McKim R, Fitsimmons R, D'Esposito M, Shevchik K, McCaw W, Schrock B, Vernon A, Frank R, Ona PZ, Freitag E, Weber E, Woods S, Kellogg E, Grant I, Basso M, Dyer B, Daniel M, Michael P, Fontanetta R, Martin P, Golden C, Gass C, Stripling A, Odland A, Holster J, Corsun-Ascher C, Olivier T, Golden C, Legaretta M, Vik P, Van Ness E, Fowler B, Noll K, Denney D, Wiechman A, Stephanie T, Greenberg B, Lacritz L, Padua M, Sandhu K, Moses J, Sordahl J, Anderson J, Wheaton V, Anderson J, Berggren K, Cheung D, Luber H, Loftis J, Huckans M, Bennett T, Dawson C, Soper H, Bennett T, Soper H, Carter K, Hester A, Ringe W, Spence J, Posamentier M, Hart J, Haley R, Fallows R, Pella R, McCoy K, O'Rourke J, Hilsabeck R, Fallows R, Pella R, McCoy K, O'Rourke J, Hilsabeck R, Gass C, Curiel R, Gass C, Stripling A, Odland A, Goldberg M, Lloyd H, Gremillion A, Nemeth D, Whittington L, Hu E, Vik P, Dasher N, Fowler B, Jeffay E, Zakzanis K, Jordan S, DeFilippis N, Collins M, Goetsch V, Small S, Mansoor Y, Homer-Smith E, Lockwood C, Moses J, Martin P, Odland A, Fontanetta R, Sharma V, Golden C, Odland A, Martin P, Perle J, Gass C, Simco E, Mittenberg W, Patt V, Minassian A, Perry W, Polott S, Webbe F, Mulligan K, Shaneyfelt K, Wall J, Thompson J, Tai C, Kiely T, Compono V, Trettin L, Gomez R, Schatzberg A, Keller J, Tsou J, Pearlson J, Sharma V, Tourgeman I, Golden C, Waldron-Perrine B, Tree H, Spencer R, McGuire A, Na S, Pangilinan P, Bieliauskas L, You S, Moses J, An K, Jeffay E, Zakzanis K, Biddle C, Fazio R, Willett K, Rolin S, O'Grady M, Denney R, Bresnan K, Erlanger D, Seegmiller R, Kaushik T, Brooks B, Krol A, Carlson H, Sherman E, Davis J, McHugh T, Axelrod B, Hanks R. Grand Rounds. Arch Clin Neuropsychol 2011. [DOI: 10.1093/arclin/acr056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Biffi A, Devan WJ, Anderson CD, Ayres AM, Schwab K, Cortellini L, Viswanathan A, Rost NS, Smith EE, Goldstein JN, Greenberg SM, Rosand J. Statin use and outcome after intracerebral hemorrhage: case-control study and meta-analysis. Neurology 2011; 76:1581-8. [PMID: 21451150 DOI: 10.1212/wnl.0b013e3182194be9] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Intracerebral hemorrhage (ICH) is a highly lethal disease of the elderly. Use of statins is increasingly widespread among the elderly, and therefore common in patients who develop ICH. Accumulating data suggests that statins have neuroprotective effects, but their association with ICH outcome has been inconsistent. We therefore performed a meta-analysis of all available evidence, including unpublished data from our own institution, to determine whether statin exposure is protective for patients who develop ICH. METHODS In our prospectively ascertained cohort, we compared 90-day functional outcome in 238 pre-ICH statin cases and 461 statin-free ICH cases. We then meta-analyzed results from our cohort along with previously published studies using a random effects model, for a total of 698 ICH statin cases and 1,823 non-statin-exposed subjects. RESULTS Data from our center demonstrated an association between statin use before ICH and increased probability of favorable outcome (odds ratio [OR] = 2.08, 95% confidence interval [CI] 1.37-3.17) and reduced mortality (OR = 0.47, 95% CI 0.32-0.70) at 90 days. No compound-specific statin effect was identified. Meta-analysis of all published evidence confirmed the effect of statin use on good outcome (OR = 1.91, 95% CI 1.38-2.65) and mortality (OR = 0.55, 95% CI 0.42-0.72) after ICH. CONCLUSION Antecedent use of statins prior to ICH is associated with favorable outcome and reduced mortality after ICH. This phenomenon appears to be a class effect of statins. Further studies are required to clarify the biological mechanisms underlying these observations.
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Affiliation(s)
- A Biffi
- Center for Human Genetic Research, Massachusetts General Hospital, 185 Cambridge Street, CPZN-6818, Boston, MA 02114, USA
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Witte H, Putsche P, Eiselt M, Schwab K, Wacker M, Leistritz L. Time-variant analysis of phase couplings and amplitude–frequency dependencies of and between frequency components of EEG burst patterns in full-term newborns. Clin Neurophysiol 2011; 122:253-66. [DOI: 10.1016/j.clinph.2010.07.004] [Citation(s) in RCA: 10] [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] [Received: 11/06/2009] [Revised: 06/14/2010] [Accepted: 07/02/2010] [Indexed: 10/19/2022]
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Milde T, Putsche P, Schwab K, Wacker M, Eiselt M, Witte H. Dynamics of directed interactions between brain regions during interburst–burst EEG patterns in quiet sleep of full-term neonates. Neurosci Lett 2011; 488:148-53. [DOI: 10.1016/j.neulet.2010.11.018] [Citation(s) in RCA: 10] [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] [Received: 08/11/2010] [Revised: 10/15/2010] [Accepted: 11/04/2010] [Indexed: 11/15/2022]
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Witte H, Leistritz L, Putsche P, Schwab K, Haueisen J, Schack B, Eiselt M, Bauer R. MODELLIERUNG UND ANALYSE VON EEG-SYNCHRONISATIONSEIGENSCHAFTEN MITTELS GEKOPPELTER NICHT LINEARER OSZILLATOREN. ACTA ACUST UNITED AC 2009. [DOI: 10.1515/bmte.2003.48.s1.146] [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: 11/15/2022]
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Brack W, Bandow N, Schwab K, Schulze T, Streck G. Identifizierung toxischer Verbindungen in Sedimenten: Ansätze zur Integration von Wirkung und Bioverfügbarkeit. ACTA ACUST UNITED AC 2009. [DOI: 10.1007/s12302-009-0057-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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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Roebuck-Spencer TM, Reeves DL, Bleiberg J, Cernich AN, Schwab K, Ivins B, Salazar A, Harvey S, Brown F, Warden D. Influence of Demographics on Computerized Cognitive Testing in a Military Sample. Military Psychology 2008. [DOI: 10.1080/08995600802118825] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [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]
Affiliation(s)
- T. M. Roebuck-Spencer
- a Center for Cognitive Neuroscience, National Rehabilitation Hospital , Washington , DC
| | | | - J. Bleiberg
- a Center for Cognitive Neuroscience, National Rehabilitation Hospital , Washington , DC
| | - A. N. Cernich
- a Center for Cognitive Neuroscience, National Rehabilitation Hospital , Washington , DC
| | - K. Schwab
- c Defense and Veterans Brain Injury Center, Walter Reed Army Medical Center , Washington , DC
| | - B. Ivins
- c Defense and Veterans Brain Injury Center, Walter Reed Army Medical Center , Washington , DC
| | | | - S. Harvey
- e Landstuhl Regional Medical Center , Germany
| | - F. Brown
- f Womack Army Medical Center , Fort Bragg , North Carolina
| | - D. Warden
- c Defense and Veterans Brain Injury Center, Walter Reed Army Medical Center , Washington , DC
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Fix M, Brown D, Schwab K, Wendell L, Smith E, Greenberg S, Rosand J, Goldstein J. Ischemic ECG Changes Predict Myocardial Injury in Patients with Intracerebral Hemorrhage. Acad Emerg Med 2007. [DOI: 10.1197/j.aem.2007.03.775] [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: 11/10/2022]
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Goldstein JN, Fazen LE, Snider R, Schwab K, Greenberg SM, Smith EE, Lev MH, Rosand J. Contrast extravasation on CT angiography predicts hematoma expansion in intracerebral hemorrhage. Neurology 2007; 68:889-94. [PMID: 17372123 DOI: 10.1212/01.wnl.0000257087.22852.21] [Citation(s) in RCA: 267] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Patients with acute intracerebral hemorrhage (ICH) presenting within 3 hours of symptom onset are known to be at increased risk of expansion. However, only a minority arrive within this time frame. Therefore, alternative markers for expansion risk are needed. OBJECTIVE To examine whether contrast extravasation on CT angiography (CTA) at presentation predicts subsequent hematoma expansion. METHODS Consecutive patients with primary ICH presenting to an urban tertiary care hospital were prospectively captured in a database. We retrospectively reviewed images for all patients receiving a CTA and at least one further CT scan within 48 hours. RESULTS Complete data were available for 104 patients. Contrast extravasation at the time of CTA was present in 56% of patients, and associated with an increased risk of hematoma expansion (22% vs 2%, p = 0.003). Patients who received a baseline CTA within 3 hours were more likely to have subsequent expansion (27%, vs 13% for those presenting later, p = 0.1). However, after multivariable analysis, contrast extravasation was the only significant predictor of hematoma expansion (OR 18, 95% CI 2.1 to 162). This effect was independent of time to presentation. CONCLUSIONS Contrast extravasation is independently associated with hematoma expansion. Patients presenting within the first few hours after symptom onset have traditionally been considered those at highest risk of expansion. However, for those presenting later, the presence of contrast may be a useful marker to guide therapies aimed at decreasing this risk.
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Affiliation(s)
- J N Goldstein
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA 02114, USA.
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Frasch MG, Müller T, Wicher C, Weiss C, Löhle M, Schwab K, Schubert H, Nathanielsz PW, Witte OW, Schwab M. Fetal body weight and the development of the control of the cardiovascular system in fetal sheep. J Physiol 2007; 579:893-907. [PMID: 17218361 PMCID: PMC2151374 DOI: 10.1113/jphysiol.2006.124800] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [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: 01/08/2023] Open
Abstract
Reduced birth weight predisposes to cardiovascular diseases in later life. We examined in fetal sheep at 0.76 (n = 18) and 0.87 (n = 17) gestation whether spontaneously occurring variations in fetal weight affect maturation of autonomic control of cardiovascular function. Fetal weights at both gestational ages were grouped statistically in low (LW) and normal weights (NW) (P < 0.01). LW fetuses were within the normal weight span showing minor growth dysproportionality at 0.76 gestation favouring heart and brain, with a primary growth of carcass between 0.76 and 0.87 gestation (P < 0.05). While twins largely contributed to LW fetuses, weight differences between singletons and twins were absent at 0.76 and modest at 0.87 gestation, underscoring the fact that twins belong to normality in fetal sheep not constituting a major malnutritive condition. Mean fetal blood pressure (FBP) of all fetuses was negatively correlated to fetal weight at 0.76 but not 0.87 gestation (P < 0.05). At this age, FBP and baroreceptor reflex sensitivity were increased in LW fetuses (P < 0.05), suggesting increased sympathetic activity and immaturity of circulatory control. Development of vagal modulation of fetal heart rate depended on fetal weight (P < 0.01). These functional associations were largely independent of twin pregnancies. We conclude, low fetal weight within the normal weight span is accompanied by a different trajectory of development of sympathetic blood pressure and vagal heart rate control. This may contribute to the development of elevated blood pressure in later life. Examination of the underlying mechanisms and consequences may contribute to the understanding of programming of cardiovascular diseases.
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Affiliation(s)
- M G Frasch
- Department of Neurology, Friedrich Schiller University, D-07740 Jena, Germany
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Schwab K, Eiselt M, Putsche P, Helbig M, Witte H. Time-variant parametric estimation of transient quadratic phase couplings between heart rate components in healthy neonates. Med Biol Eng Comput 2006; 44:1077-83. [PMID: 17093954 DOI: 10.1007/s11517-006-0120-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2005] [Accepted: 10/10/2006] [Indexed: 10/23/2022]
Abstract
The heart rate variability (HRV) can be taken as an indicator of the coordination of the cardio-respiratory rhythms. Bispectral analysis using a direct (fast Fourier transform based) and time-invariant approach has shown the occurrence of a quadratic phase coupling (QPC) between a low-frequency (LF: 0.1 Hz) and a high-frequency (HF: 0.4-0.6 Hz) component of the HRV during quiet sleep in healthy neonates. The low-frequency component corresponds to the Mayer-Traube-Hering waves in blood pressure and the high-frequency component to the respiratory sinus arrhythmia (RSA). Time-variant, parametric estimation of the bispectrum provides the possibility of quantifying QPC in the time course. Therefore, the aim of this work was a parametric, time-variant bispectral analysis of the neonatal HRV in the same neonates used in the direct, time-invariant approach. For the first time rhythms in the time course of QPC between the HF component and the LF component could be shown in the neonatal HRV.
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Affiliation(s)
- K Schwab
- Institute of Medical Statistics, Computer Sciences and Documentation, Medical Faculty of the Friedrich Schiller University Jena, Bachstr. 18, 07740 Jena, Germany.
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Bader J, Neumann B, Schwab K, Popovic M, Scheler C, Bajpai R. α-Amylase Production in Fed-Batch Cultivation ofBacillus caldolyticus. CHEM-ING-TECH 2005. [DOI: 10.1002/cite.200590158] [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: 11/10/2022]
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Schwab K, Eiselt M, Schelenz C, Witte H. Time-variant parametric estimation of transient quadratic phase couplings during electroencephalographic burst activity. Methods Inf Med 2005; 44:374-83. [PMID: 16113760] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
OBJECTIVES Electroencephalographic burst activity characteristic of burst-suppression pattern (BSP) in sedated patients and of burst-interburst pattern (BIP) in the quiet sleep of healthy neonates have similar linear and non-linear signal properties. Strong interrelations between a slow frequency component and rhythmic, spindle-like activities with higher frequencies have been identified in previous studies. Time-varying characteristics of BSP and BIP prevent a definite patternrelated analysis. A continuous estimation of the bispectrum is essential to analyze these patterns. Parametric bispectral approaches provide this opportunity. METHODS The adaptation of an AR model leads to a parametric bispectrum by using the transfer function of the estimated AR filter. Time-variant parametric bispectral approaches require an estimation of AR parameters which consider higher order moments to preserve phase information. Accordingly, a time-variant parametric estimation of the bispectrum was introduced. Data driven simulations were performed to provide optimal parameters. BSP (12 patients) and BIP (6 neonates) were analyzed using this novel approach. RESULTS Significant differences in the time course of burst pattern during BSP and burst-like pattern before the onset of BSP could be shown. A rhythmic quadratic phase coupling (period 10 sec) was identified during BIP in all neonates. CONCLUSION Quadratic phase couplings during BSP increases in the time course depending on depth of sedation. The visually detected burst activity in BIP is only the temporarily observable EEG correlate of a hidden neural process. Time-variant bispectral approaches offer the possibility of a better characterization of underlying neural processes leading to improved diagnostic tools used in clinical routine.
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Affiliation(s)
- K Schwab
- Institute of Medical Statistics, Computer Science and Documentation, Medical Faculty of the Friedrich Schiller University of Jena, Jena, Germany.
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Witte H, Putsche P, Schwab K, Eiselt M, Helbig M, Suesse T. On the spatio-temporal organisation of quadratic phase-couplings in ‘tracé alternant’ EEG pattern in full-term newborns. Clin Neurophysiol 2004; 115:2308-15. [PMID: 15351372 DOI: 10.1016/j.clinph.2004.05.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2004] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The time courses of quadratic phase-coupling (QPC) of electroencephalographic burst and interburst patterns of the 'trace alternant' (TA) in full-term newborns have been quantified. METHODS Using the Gabor expansion, a fast Fourier transformation based method, biamplitude, bicoherence and phase-bicoherence time courses of both burst and interburst patterns have been determined (common average reference EEG recordings). With a frequency resolution of 0.25 Hz and a frequency grid of 1-1.5 <==> 3.5-4.5 Hz (region-of-interest), a number of 15 frequency pairs result. These pairs have been investigated. RESULTS The burst and the interburst patterns are characterized by temporally and topographically different QPC profiles. All differences are dominant at the electrode Fp1 followed by Fp2. There is a significant difference (combined multiple and global test strategy) in the QPC characteristics between both patterns within the time period from 0.75 to 1.5 s after the pattern onset at electrode Fp1. The maximal QPC in burst patterns (especially at Fp1) can be observed during this time period. In contrast to this finding, maximal QPC in interburst patterns (at Fp1) are reached immediately after the onset and at 3 s. Summarising all findings, a QPC-rhythm of 0.1 Hz during TA can be assumed. CONCLUSIONS It can be assumed that the QPC rhythm of the TA is generated by a pattern-spanning time-variant phase-locking process and there are indications for a possible correspondence between the QPC rhythm and vegetative rhythms. SIGNIFICANCE This study showed that advanced, time-variant analysis methods quantifying QPC rhythms are able to add new scientific information to the understanding of nature, characteristics and significance of TA in the neonatal EEG.
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Affiliation(s)
- H Witte
- Institute of Medical Statistics, Computer Science and Documentation, Friedrich Schiller University, 07740 Jena, Germany.
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Schwab M, Schwab K, Kott M, Szeto HH. Intrauterine Development of Sleep States. KLIN NEUROPHYSIOL 2004. [DOI: 10.1055/s-2004-832171] [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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Eiselt M, Schwab K, Putsche P, Witte H, Zwiener U. Integrative Cortical Functions in the Immature Brain – Investigations in Human Newborns using EEG. KLIN NEUROPHYSIOL 2004. [DOI: 10.1055/s-2004-831962] [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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Shainberg A, Safran N, Balas N, Zinman T, Isaac A, Schwab K, Akabayov B, Shneyvays V. The role of A1/A3 adenosine receptor activation in reduction of cardiomyocyte injury caused by hypoxic stress and in induction of apoptosis in rat cardiomyocyte cultures. Adv Exp Med Biol 2002; 486:201-5. [PMID: 11783485 DOI: 10.1007/0-306-46843-3_41] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Affiliation(s)
- A Shainberg
- Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel
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Weissenburger J, Lanham R, Rosner M, Schwab K. Do self-ratings, family/friend ratings and neuropsychological performance reflect awareness following TBI? Arch Clin Neuropsychol 2000. [DOI: 10.1093/arclin/15.8.822a] [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: 11/14/2022] Open
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Salazar AM, Warden DL, Schwab K, Spector J, Braverman S, Walter J, Cole R, Rosner MM, Martin EM, Ecklund J, Ellenbogen RG. Cognitive rehabilitation for traumatic brain injury: A randomized trial. Defense and Veterans Head Injury Program (DVHIP) Study Group. JAMA 2000; 283:3075-81. [PMID: 10865301 DOI: 10.1001/jama.283.23.3075] [Citation(s) in RCA: 249] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT Traumatic brain injury (TBI) is a principal cause of death and disability in young adults. Rehabilitation for TBI has not received the same level of scientific scrutiny for efficacy and cost-efficiency that is expected in other medical fields. OBJECTIVE To evaluate the efficacy of inpatient cognitive rehabilitation for patients with TBI. DESIGN AND SETTING Single-center, parallel-group, randomized trial conducted from January 1992 through February 1997 at a US military medical referral center. PATIENTS One hundred twenty active-duty military personnel who had sustained a moderate-to-severe closed head injury, manifested by a Glasgow Coma Scale score of 13 or less, or posttraumatic amnesia lasting at least 24 hours, or focal cerebral contusion or hemorrhage on computed tomography or magnetic resonance imaging. INTERVENTIONS Patients were randomly assigned to an intensive, standardized, 8-week, in-hospital cognitive rehabilitation program (n=67) or a limited home rehabilitation program with weekly telephone support from a psychiatric nurse (n=53). MAIN OUTCOME MEASURES Return to gainful employment and fitness for military duty at 1-year follow-up, compared by intervention group. RESULTS At 1-year follow-up, there was no significant difference between patients who had received the intensive in-hospital cognitive rehabilitation program vs the limited home rehabilitation program in return to employment (90% vs 94%, respectively; P=.51; difference, 4% [95% confidence interval ¿CI¿, -5% to 14%]) or fitness for duty (73% vs 66%, respectively; P=. 43; difference, 7% [95% CI, -10% to 24%]). There also were no significant differences in cognitive, behavioral, or quality-of-life measures. In a post-hoc subset analysis of patients who were unconscious for more than 1 hour (n = 75) following TBI, the in-hospital group had a greater return-to-duty rate (80% vs 58%; P=. 05). CONCLUSIONS In this study, the overall benefit of in-hospital cognitive rehabilitation for patients with moderate-to-severe TBI was similar to that of home rehabilitation. These findings emphasize the importance of conducting randomized trials to evaluate TBI rehabilitation interventions. JAMA. 2000;283:3075-3081
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Affiliation(s)
- A M Salazar
- Defense and Veterans Head Injury Program, Bldg 1, Room B210, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA.
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Schulz S, Huber A, Schwab K, Paulsen R. A novel Ggamma isolated from Drosophila constitutes a visual G protein gamma subunit of the fly compound eye. J Biol Chem 1999; 274:37605-10. [PMID: 10608815 DOI: 10.1074/jbc.274.53.37605] [Citation(s) in RCA: 23] [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: 11/06/2022] Open
Abstract
Visual transduction in the compound eye of flies is a well established model system for the study of G protein-coupled transduction pathways. To characterize key components of the phototransduction cascade we performed substractive hybridization screening. We cloned the cDNA coding for the visual Ggamma (Ggamma(e)) subunit from Drosophila which had so far eluded identification at the molecular level. Northern blot analysis revealed the presence of a major, 1.4-kilobase(kb) Ggamma(e) transcript and two minor transcripts of 1.8 and 6 kb in size. The major 1.4-kb mRNA is expressed preferentially in the eye. The spatial expression pattern determined for Ggamma(e) as well as co-immunoprecipitation experiments demonstrated that Ggamma(e) dimerizes with Gbeta(e) to form the heterodimeric Gbetagamma subunit which functions in visual transduction in the Drosophila compound eye. Ggamma(e) shares common characteristics with the visual Ggamma subunits of human rod and cone photoreceptors although different classes of Galpha subunits are employed in vertebrate and invertebrate phototransduction. By the molecular cloning and characterization of the visual gamma subunit of Drosophila one of the few missing links in the well studied Drosophila phototransduction cascade has been characterized to complete our knowledge about the Drosophila visual transduction pathway.
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Affiliation(s)
- S Schulz
- Department of Cell and Neurobiology, Institute of Zoology, University of Karlsruhe, 76128 Karlsruhe, Germany
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Spector J, Warden D, Salazar A, Schwab K, Chervinsky A, Braverman S. Efficacy of inpatient multidisciplinary rehabilitation versus low intensity home management after moderate-severe brain injury: Cognitive and psychological outcome following a controlled, randomized rehabilitation trial. Arch Clin Neuropsychol 1999. [DOI: 10.1093/arclin/14.8.797] [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: 11/12/2022] Open
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Ommaya AK, Salazar AM, Schwab K. Chapter 7. Defense and Veterans Head Injury Program: a model injury registry. Mil Med 1999; 164:1-21. [PMID: 10847816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
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Chou WH, Huber A, Bentrop J, Schulz S, Schwab K, Chadwell LV, Paulsen R, Britt SG. Patterning of the R7 and R8 photoreceptor cells of Drosophila: evidence for induced and default cell-fate specification. Development 1999; 126:607-16. [PMID: 9895309 DOI: 10.1242/dev.126.4.607] [Citation(s) in RCA: 113] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Opsin gene expression in the R7 and R8 photoreceptor cells of the Drosophila compound eye is highly coordinated. We have found that the R8 cell specific Rh5 and Rh6 opsins are expressed in non-overlapping sets of R8 cells, in a precise pairwise fashion with Rh3 and Rh4 in the R7 cells of individual ommatidia. Removal of the R7 cells in sevenless, boss or sina mutants, disrupts Rh5 expression and dramatically increases the number of Rh6-expressing R8 cells. This suggests that the expression of Rh5 may be induced by an Rh3-expressing R7 cell, whereas Rh6 expression is most likely a default state of the R8 cell. We found that the paired expression of opsin genes in the R7 and R8 cells occurs in a sevenless and boss independent manner. Furthermore, we found that the generation of both Rh3- and Rh4-expressing R7 cells can occur in the absence of an R8 cell. These results suggest that the specification of opsin expression in the R7 cells may occur autonomously, whereas the R7 photoreceptor cell may be responsible for regulating a binary developmental switch between induced and default cell-fates in the R8 cell.
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Affiliation(s)
- W H Chou
- Institute of Biotechnology and Department of Molecular Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78245-3207, USA.
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Chervinsky AB, Ommaya AK, deJonge M, Spector J, Schwab K, Salazar AM. Motivation for traumatic brain injury rehabilitation questionnaire (MOT-Q): reliability, factor analysis, and relationship to MMPI-2 variables. Arch Clin Neuropsychol 1998; 13:433-46. [PMID: 14590608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
A Likert scale questionnaire was developed to assess motivation for postacute rehabilitation by traumatic brain injury patients. Items were designed to reflect head-injured individuals' statements about their attitudes toward head injury rehabilitation. Factors such as denial of illness, anger, compliance with treatment, and medical information seeking behavior were used to assess unfavorable and favorable components of motivation. Reliability was assessed using Cronbach's Alpha, which was found to be 0.91 for the total scale. Four factor analysis derived subscales were identified: Lack of Denial, Interest in Rehabilitation, Lack of Anger, and Reliance on Professional Help. Correlation and multiple regression analyses demonstrated moderate relationships between MOT-Q and several MMPI-2 variables largely related to indicators of somatic distress, depression and capacity for self-sufficiency. Lack of Denial subscale showed the strongest relationship to MMPI-2 of all MOT-Q variables, while Interest in Rehabilitation showed the best correlation to the MOT-Q total.
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Affiliation(s)
- A B Chervinsky
- Defense and Veterans Head Injury Program, Walter Reed Army Medical Center, USA
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Chervinsky AB, Ommaya AK, deJonge M, Spector J, Schwab K, Salazar AM. Motivation for Traumatic Brain Injury Rehabilitation Questionnaire (MOT-Q): Reliability, Factor Analysis, and Relationship to MMPI-2 Variables. Arch Clin Neuropsychol 1998. [DOI: 10.1093/arclin/13.5.433] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bentrop J, Schwab K, Pak WL, Paulsen R. Site-directed mutagenesis of highly conserved amino acids in the first cytoplasmic loop of Drosophila Rh1 opsin blocks rhodopsin synthesis in the nascent state. EMBO J 1997; 16:1600-9. [PMID: 9130705 PMCID: PMC1169764 DOI: 10.1093/emboj/16.7.1600] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The cytoplasmic surface of Drosophila melanogaster Rh1 rhodopsin (ninaE) harbours amino acids which are highly conserved among G-protein-coupled receptors. Site-directed mutations which cause Leu81Gln or Asn86Ile amino acid substitutions in the first cytoplasmic loop of the Rh1 opsin protein, are shown to block rhodopsin synthesis in the nascent, glycosylated state from which the mutant opsin is degraded rapidly. In mutants Leu81Gln and Asn86Ile, only 20-30% and <2% respectively, of functional rhodopsins are synthesized and transported to the photoreceptive membrane. Thus, conserved amino acids in opsin's cytoplasmic surface are a critical factor in the interaction of opsin with proteins of the rhodopsin processing machinery. Photoreceptor cells expressing mutant rhodopsins undergo age-dependent degeneration in a recessive manner.
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Affiliation(s)
- J Bentrop
- Zoologisches Institut, Lehrstuhl 1, Universität Karlsruhe (T.H), Germany
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