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8. Surviving a Self-inflicted Transorbital Pen Intrusion to the Cerebellum: Case Report.

Author

Breuskin, David, Ketter, Ralf, and Oertel, Joachim

Subjects
*CEREBELLUM, *VISION, *COMPUTED tomography, *INTENSIVE care units, *BRAIN injuries
Abstract

Background Although intracranial traumas by penetrating foreign objects are not absolute rarities, the nature of trauma, the kind of object, and its trajectory make them a one of a kind case every time they occur. Whereas high-velocity traumas mostly result in fatalities, it is the low-velocity traumas that demand an individualized surgical strategy. Methods We present a case report of a 33-year-old patient who was admitted to our department with a self-inflicted transorbital pen injury to the brain. The authors recall the incident and the technique of the pen removal. Results Large surgical exposure of the pen trajectory was considered too traumatic. Therefore, we opted to remove the pen and have an immediate postoperative computed tomography (CT) scan. Due to its fragility, the pen case could only be removed with a screwdriver, inserted into the case. Post-op CT scan showed a small bleeding in the right peduncular region, which was treated conservatively. The patient was transferred back to intensive care unit and woken up the next day. She lost visual function on her right eye, but suffered from no further neurologic deficit. Conclusion Surgical management of removal of intracranial foreign bodies is no routine procedure. Although some would favor a large surgical exposure, we could not think of an approach to do so without maximum surgical efforts. We opted for a minimal surgical procedure with immediate CT scan and achieved an optimal result. We find this case to be worth considering when deciding on a strategy in the future. [ABSTRACT FROM AUTHOR]

Published
2023
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11. Additional file 6 of Bisulfite profiling of the MGMT promoter and comparison with routine testing in glioblastoma diagnostics

Author

Tierling, Sascha, J��rgens-Wemheuer, Wiebke M., Leismann, Alea, Becker-Kettern, Julia, Scherer, Michael, Wrede, Arne, Breuskin, David, Urbschat, Steffi, Sippl, Christoph, Oertel, Joachim, Schulz-Schaeffer, Walter J., and Walter, J��rn

Abstract

Additional file 6: Fig. S3. Kaplan���Meier survival plots including p values obtained from Cox regression model analysis and confidence intervals (blue/red); (A) average DNA methylation of CpG -48, CpG -61 and CpG -64, (B) TCGA 450K array-based DNA methylation of CpG -48 (cg01341123), (C) DNA methylation of CpG +18 in the presented cohort, (D) TCGA 450K array-based DNA methylation of CpG +18 (cg12981137).

Published
2022
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12. Additional file 4 of Bisulfite profiling of the MGMT promoter and comparison with routine testing in glioblastoma diagnostics

Author

Tierling, Sascha, J��rgens-Wemheuer, Wiebke M., Leismann, Alea, Becker-Kettern, Julia, Scherer, Michael, Wrede, Arne, Breuskin, David, Urbschat, Steffi, Sippl, Christoph, Oertel, Joachim, Schulz-Schaeffer, Walter J., and Walter, J��rn

Abstract

Additional file 4: Fig. S2. (A) DNA methylation heatmap of all CpGs in the MGMTup amplicon in malignant astrocytoma samples; CpGs are numbered relative to the TSS; grey lines represent missing data for the respective sample; CpGs present on the 450K/850K(EPIC) BeadChip arrays are indicated on top. CpGs grouped into five methylation domains (D1-D5) are highlighted in different colors with D1 and D2 represented by single CpGs (CpG -68 and CpG -67). Samples were ordered according to the sample clustering in MGMTe1 for clarity reasons. (B) Scatter plot with trend lines and confidence intervals based on local regression analysis; each dot represents the averaged DNA methylation of a sample per sequenced amplicon. Dots are colored based on the average methylation state in the exon 1 region: red=highly methylated (>30%), purple=intermediately methylated (between 9% and 30%), blue= lowly methylated (

Published
2022
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13. Additional file 3 of Bisulfite profiling of the MGMT promoter and comparison with routine testing in glioblastoma diagnostics

Author

Tierling, Sascha, J��rgens-Wemheuer, Wiebke M., Leismann, Alea, Becker-Kettern, Julia, Scherer, Michael, Wrede, Arne, Breuskin, David, Urbschat, Steffi, Sippl, Christoph, Oertel, Joachim, Schulz-Schaeffer, Walter J., and Walter, J��rn

Abstract

Additional file 3: Fig. S1. MSP on human PBL and EpiTect Control methylated bisulfite-treated DNA with proposed primer pairs designed based on methylation domain modelling; electrophoretic separation of MSP reactions on a LONZA FlashGel system using 2.2% gels (Flash GelTM DNA cassettes, #57032, Biozym Scientific GmbH, Germany); Marker = Flash GelTM DNA marker (50bp���1.5kb #57033), PBL = peripheral blood leukocytes, bisulfite-converted DNA, EpiTect = EpiTect Control DNA (human), methylated and bisulfite-converted (Qiagen #59655); NTC = no template control.

Published
2022
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14. Metastasen in der Sellaregion und an der Hypophyse - eine Fallserie seltener Metastasierungswege

Author

Linsler, Stefan, Senger, Sebastian, Breuskin, David, and Oertel, Joachim

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Objective: The sellar region is an unusual site for metastatic spread, but as patients with metastatic malignancy are living longer, it may become more prevalent in an interdisciplinary center. Compression of important anatomy adjacent to the sella may produce disabling symptoms and endocrine derangement,[for full text, please go to the a.m. URL], 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Published
2021

17. Reaching the sellar region endonasally - one or both nostrils? A cadaveric morphometric study

Author

Linsler, Stefan, Breuskin, David, Tschernig, Thomas, and Oertel, Joachim

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Objective: The purpose of this study was to evaluate the effect of posterior septectomy size on surgical exposure and surgical freedom during the endoscopic transsphenoidal approach to the sellar and parasellar region. Methods: A mononostril and binostril approach to sellar region was performed[for full text, please go to the a.m. URL], 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Published
2018
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18. Resection of osseous sphenoid meningiomas and reconstruction of the skull base in a combined method using a CAD PMMA-Implant

Author

Breuskin, David, Fischer, Gerrit, Linsler, Stefan, and Oertel, Joachim

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Objective: Resection of bone infiltrating meningeomas of the sphenoid plane, involving the orbital walls, is a highly challenging neurosurgical procedure. Complete tumour resection, cranial reconstruction as well as cosmetic satisfaction are key points that need to be considered and fulfilled to the[for full text, please go to the a.m. URL], 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Published
2018
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19. First clinical experience using a novel shunt reservoir with a telemetric pressure probe for permanent implantation

Author

Heckelmann, Michael, Antes, Sebastian, Breuskin, David, Oertel, Joachim, and Tschan, Christoph Albrecht

Subjects
ddc: 610, icp, 610 Medical sciences, Medicine, shunt sensor reservoir, telemetric
Abstract

Objective: While modern shunt treatment technically evolves, valve settings are still mainly guided by clinical symptoms and imaging. Information about the actual intracranial pressure is desired as parameters for valve adjustment. In this regard an unique device has been developed to allow measurement[for full text, please go to the a.m. URL], 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Published
2015

20. Shunt-valve adjustment assisted by telemetric long-term ICP monitoring

Author

Heckelmann, Michael, Antes, Sebastian, Breuskin, David, Oertel, Joachim, and Tschan, Christoph A.

Subjects
ddc: 610, telemetry, ICP, 610 Medical sciences, Medicine, hydrocephalus
Abstract

Objective: Shunt treated patients are prone to develop symptomatic over- or underdrainage. To deal with these complications, adjustable valves have been developed. The technical progress in shunt systems with combined adjustable differential pressure and adjustable gravitational valves causes a new [for full text, please go to the a.m. URL], 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Published
2014

21. Confocal laser endomicroscopy - a novel technique of diagnostics in neurosurgery?

Author

Breuskin, David, DiVincenzo, Jana, Kim, Yoo-Jin, Urbschat, Steffi, and Oertel, Joachim

Subjects
histology, ddc: 610, confocal laser endomicroscopy, tumours, 610 Medical sciences, Medicine
Abstract

Objective: The appropriate extent of resection and especially the intraoperative distinction between normal and abnormal tissue leads to a successful tumour resection. Considering its benefits in gastroenterology or pulmonology, our goal is to establish confocal endomicroscopy in neurosurgery, providing[for full text, please go to the a.m. URL], 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Published
2013
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22. Comparing confocal laser endomicroscopy to instantaneous section

Author

Breuskin, David, DiVincenzo, Jana, Kim, Yoo-Jin, Urbschat, Steffi, and Oertel, Joachim

Subjects
histology, ddc: 610, confocal laser endomicroscopy, tumours, 610 Medical sciences, Medicine
Abstract

Objective: Defining margins of cerebral tumours often proves the most challenging part in brain surgery. Achieving an appropriate extent of resection can further determine the therapeutic success. After establishing diagnostic criteria for confocal laser endomicroscopy, we compared instantaneous sections[for full text, please go to the a.m. URL], 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Published
2013

25. Konfokale Laserendomikroskopie in der Neurochirurgie : Erste Erfahrungen

Author

Breuskin, David Pierre Henri

Abstract

Die Behandlung hirneigener Tumore ist ein wesentlicher Behandlungspfeiler der Neurochirurgie. Hierbei gilt es den Patienten so zu behandeln, dass ein maximaler therapeutischer Erfolg mit geringst möglichem operativen Schaden einhergeht. Technische Entwicklungen im Laufe der vergangenen Jahrzehnte haben die Qualität der neurochirurgischoperativen Therapie stetig vorangebracht, sodass mit minimalinvasiven Techniken eine möglichst hohe Radikalität erbracht werden kann. Aktuell muss das resezierte Gewebe histopathologisch untersucht werden, um eine diagnostische Sicherheit zur Ätiologie des Gewebes zu erlangen. Die konfokale Laserendomikroskopie ermöglicht die Untersuchung von Gewebe auf zellulärer Ebene in situ, was sie bereits zu einer viel versprechenden Untersuchungstechnik in der Gastroenterologie oder Pneumologie gemacht hat. Diese Arbeit hat zum Ziel, diese Technik in der Neurochirurgie zu untersuchen und zu etablieren. Wäre es möglich, das Gewebe bereits in situ auf seine Dignität zu untersuchen, so könne man die operative Qualität und Patientensicherheit erhöhen, da das Gewebe nicht erst reseziert werden müsste um diese Aussagen zu treffen, sondern nur gesichert pathologisches Gewebe entfernt werden könnte. In dieser Arbeit bedient sich der Autor des EndoMag1 der Karl-Storz GmbH, einem rigiden Endoskop mit einem Hopkins-Stablinsensystem. Mit Hilfe diesen Endoskops wurden zunächst das Gehirn eines frisch geschlachteten Schweines, sowie 83 humaner Tumorproben verschiedener Ätiologien untersucht. Das dargestellt Bildmaterial wurde auf seine Morphologie untersucht und mit der Zusammenarbeit eines Neuropathologen verschiedene Kriterien der Befundung etabliert, sodass eine diagnostische Grundlage geschaffen wurde, nach der im Anschluss 100 humane Proben im Vergleich zum Schnellschnitt untersucht werden konnten. Hierbei konnte die richtige Diagnose mit einer hohen respektiven Sensitivität und Spezifizität bei high grade Gliomen (0,81/0,85), low grade Gliomen (0,9/0,93) Schwannomen (0,87/1) und Meningeomen (0,82/0,95) erzielt werden. Metastasen konnten hingegen nur mit einer geringen Sensitivität und Spezifizität von 0,07 respektive 0,94 diagnostiziert werden. Insgesamt konnte nachgewiesen werden, dass die konfokale Laserendomikroskopie eine vielversprechende Technik darstellt, welche unterstützend die neurochirurgisch-operative Behandlung weiterentwickelt, jedoch noch einen langen Weg der Entwicklung vor sich hat.

Published
2018

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