5 results on '"Rueger, M. A."'
Search Results
2. Primary Stroke Unit Treatment Followed by Very Early Carotid Endarterectomy for Carotid Artery Stenosis after Acute Stroke.
- Author
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Aleksic, M., Rueger, M. A., Lehnhardt, F. G., Sobesky, J., Matoussevitch, V., Neveling, M., Heiss, W. D., Brunkwall, J., and Jacobs, A. H.
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CEREBROVASCULAR disease , *ENDARTERECTOMY , *STENOSIS , *CARDIOVASCULAR diseases ,CAROTID artery stenosis - Abstract
Background: Although it is recognized that carotid endarterectomy (CEA) is the treatment of choice in symptomatic internal carotid artery (ICA) stenosis, in the past, very early CEA has been shown to carry substantial risks. We assessed an interdisciplinary concept of very early CEA in patients with high-grade (>70%) symptomatic ICA stenosis at a single center. Patients and Methods: The course of treatment and outcomes of patients who underwent CEA as early as possible after being referred to the stroke unit for symptoms of transient ischemic attack and stroke were prospectively evaluated, including the following parameters: age, severity of ischemia-related symptoms according to the modified Rankin scale, duration of symptoms until admission, multimodal imaging findings (color-coded duplex, cranial computed tomography, magnetic resonance imaging, positron emission tomography), duration until CEA, perioperative course and complications, as well as duration of in-hospital care. Results: Fifty consecutive patients (median age 68 years, range 44-90) with clinical and imaging signs of transient ischemic attack (n = 19) or stroke (n = 31) were included from January 2000 until December 2004. All except 1 patient showed a preoperative Rankin <4. There was a median time period of 6 h between the onset of symptoms and admission (range 1 h to 15 days) and a median duration of 4 days after admission until operation (range 1-21 days). Seven patients underwent CEA of the contralateral, severely stenosed ICA after symptomatic ipsilateral ICA occlusion. Four out of 5 patients who primarily underwent systemic thrombolysis recovered almost completely. Three patients (6%) experienced a clinical deterioration before surgery. In the majority of patients (43/50), CEA was performed under local anesthesia with selective shunt use which became necessary in 26%. Three patients (6%) had postoperative worsening due to new infarcts. In 2 cases, an intracerebral hemorrhage occurred, of which 1 remained asymptomatic. In 1 case, surgical revision was necessary because of an ICA thrombosis without permanent neurological decline. Patients were discharged after a median time of 14.5 days (range 4-44). Conclusions: After careful selection and preparation in a stroke unit, patients with acute stroke due to carotid stenosis can undergo very early CEA under local anesthesia with a perioperative risk comparable with the risk of later endarterectomy, therefore preventing very early stroke recurrences. [ABSTRACT FROM AUTHOR]
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- 2006
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3. Long-Term Remission in Progressive Multifocal Leukoencephalopathy Caused by Idiopathic CD4+ T Lymphocytopenia: A Case Report.
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Rueger, M. A., Miletic, H., Dorries, K., Wyen, C., Eggers, C., Deckert, M., Faetkenheuer, G., and Jacobs, A. H.
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VIRUSES , *ANTIRETROVIRAL agents , *ANTIVIRAL agents , *CENTRAL nervous system , *OPPORTUNISTIC infections , *HIV-positive persons , *HIV infections - Abstract
Progressive multifocal leukoencephalopathy is caused by JC virus, an opportunistic infection of the central nervous system. Antiretroviral treatment for progressive multifocal leukoencephalopathy in human immunodeficiency virus-infected patients is beneficial, but few data exist for patients who are not infected with human immunodeficiency virus. Idiopathic CD4+ T lymphocytopenia excludes human immunodeficiency virus infection. We describe a patient with progressive multifocal leukoencephalopathy with underlying idiopathic CD4+ T lymphocytopenia in whom functional recovery occurred without antiviral therapy. [ABSTRACT FROM AUTHOR]
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- 2006
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4. Variability in infectivity of primary cell cultures of human brain tumors with HSV-1 amplicon vectors.
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Rueger, M. A., Winkeler, A., Miletic, H., Kaestle, C., Richter, R., Schneider, G., Hilker, R., Heneka, M. T., Ernestus, R. I., Hampl, J. A., Fraefel, C., and Jacobs, A. H.
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CELL culture , *BRAIN tumors , *HERPES simplex virus , *INFECTION , *MICROBIAL virulence , *NEUROSURGERY , *GENETIC transduction , *GLIOMAS - Abstract
We investigated the variability in infectivity of cells in primary brain tumor samples from different patients using an HSV-1 amplicon vector. We studied the infectivity of HSV-1 amplicon vectors in tumor samples derived from neurosurgical resections of 20 patients. Cells were infected with a definite amount of HSV-1 amplicon vector HSV-GFP. Transduction efficiency in primary tumor cell cultures was compared to an established human glioma line. Moreover, duration of transgene expression was monitored in different tumor cell types. All primary cell cultures were infectable with HSV-GFP with variable transduction efficiencies ranging between 3.0 and 42.4%from reference human Gli36?EGFR glioma cells. Transduction efficiency was significantly greater in anaplastic gliomas and meningiomas (26.7±17.4%) compared to more malignant tumor types (glioblastomas, metastases; 11.2±8.5%; P=0.05). To further investigate the possible underlying mechanism of this variability, nectin-1/HevC expression was analyzed and was found to contribute, at least in part, to this variability in infectability. The tumor cells expressed the exogenous gene for 7 to 61 days with significant shorter expression in glioblastomas (18±13?d) compared to anaplastic gliomas (42±24?d; P<0.05). Interindividual variability of infectivity by HSV-1 virions might explain, at least in part, why some patients enrolled in gene therapy for glioblastoma in the past exhibited a sustained response to HSV-1-based gene- and virus therapy. Infectivity of primary tumor samples from respective patients should be tested to enable the development of efficient and safe herpes vector-based gene and virus therapy for clinical application.Gene Therapy (2005) 12, 588-596. doi:10.1038/sj.gt.3302462 Published online 27 January 2005 [ABSTRACT FROM AUTHOR]
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- 2005
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5. Infection rates in patients undergoing primary knee arthroplasty with pre-existing orthopaedic fixation-devices.
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Klatte, T. O., Schneider, M. M., Citak, M., Oloughlin, P., Gebauer, M., Rueger, M., Gehrke, T., and Kendoff, D.
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KNEE surgery , *ARTHROPLASTY , *FRACTURE fixation , *KNEE diseases , *HEALTH outcome assessment , *INTERNAL fixation in fractures , *PATIENTS - Abstract
Background: Prior knee surgery in the setting of knee arthroplasty (KA) can influence the overall outcome of the procedure and render the operation more technically challenging. The effects of residual fixation devices on subsequent procedures about the knee are ill-defined. Some authors claim an increase in periprosthetic infection in this cohort of patients. The objective of this study was to evaluate the overall incidence of periprosthetic infections in patients undergoing primary KA with pre-existing osteosynthetic hardware in situ. Methods: The current investigators retrospectively reviewed 124 patients undergoing knee arthroplasty and removal of orthopaedic fixation devices, due to prior high tibial osteotomies, fracture fixation or cruciate ligament reconstruction. The exclusion criterion was a prior history of infection of the fixation device. The mean follow-up time was 5.4 years (range 15 months to 9 years). Nine patients were lost to follow-up. Results: Joint aspiration was performed two weeks prior to surgery in 53 patients (42.4%) and intra-operative samples were obtained in 106 patients (84.8%), which did not show any bacterial growth. A subacute periprosthetic infection occurred after seven months in only one patient. Conclusion: The results of the current study demonstrate that previously implanted osteosynthetic fixation devices do not significantly increase the risk of developing periprosthetic knee infections. A two-stage procedure with implant retrieval prior to total knee arthroplasty is not clinically indicated in the cohort described, amongst whom an infection rate of 0.9% was revealed. [ABSTRACT FROM AUTHOR]
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- 2013
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