Endovascular therapy in 201 patients with acute symptomatic occlusion of the internal carotid artery

Background and purpose Endovascular therapy is used increasingly for treatment of acute symptomatic internal carotid artery (ICA) occlusion, although randomized trials are lacking. Predictors of outcome are therefore of special interest. Methods From 1992 to 2010 we treated 201 patients with acute ICA occlusion with intra-arterial pharmacological thrombolysis (32), endovascular mechanical therapy (78) or a combination of both (91). All data were assessed prospectively. Results There were 76/38% patients with tandem occlusions [ICA plus middle (MCA) or anterior cerebral arteries (ACA)], 18/9% without concomitant occlusions of major intracranial arteries (ICA plus branch occlusion) and 107/53% with functional ICA-T occlusions (ICA plus MCA and ACA). Median baseline National Institute of Health Stroke Scale (NIHSS) score was 17. Good recanalization (Thrombolysis in Myocardial Infarction 2–3) was achieved in (157/201) 78% patients and good reperfusion (Thrombolysis in Cerebral Infarction 2–3) in (151/182) 83%. Better recanalization rates were obtained with mechanical approaches, with/without thrombolytics (78/91 = 86% and 64/78 = 82%) compared with pharmacological thrombolysis only (15/32 = 47%; P < 0.001). Twelve patients (6%) suffered symptomatic intracranial haemorrhages. The 3-month outcome was favourable [modified Rankin score (mRS) 0–2] in 54/28% patients and moderate (mRS 0–3) in 90/46%; 60/31% patients died. Only 17/16% patients with functional ICA-T occlusions had favourable outcomes compared with 32/44% with tandem occlusions and 5/31% with ICA plus cerebral branch occlusions (P = 0.001). In multivariate analysis age [odds ratio (OR) = 0.96, 95% confidence interval (CI) = 0.93–0.98], NIHSS on admission (OR = 0.9, 95% CI = 0.83–0.98) and functional ICA-T occlusion (OR = 0.35, 95% CI = 0.16–0.77) were non-modifiable predictors, and vessel recanalization was the only modifiable predictor of outcome (OR = 9.30, 95% CI = 2.03–42.63). Conclusions The outcome of acute symptomatic ICA occlusion is poor. However, recanalization is associated with better outcome, and recanalization rates with mechanical techniques were superior to merely pharmacological recanalization attempts.

Morbidity in 201 patients with small sized meningioma treated by microsurgery

The management of patients with small, often asymptomatic meningiomas is controversial and includes observation, microsurgery (MS) and stereotactic radiosurgery (SRS). The purpose of this retrospective study was to analyze the morbidity and the extent of removal after MS for small (< or =3 cm) intracranial meningiomas and compare these results to those of SRS reported in the literature.

Preventive effects of octreotide (SMS 201-995) on diabetic ketogenesis during insulin withdrawal

1. Exogenous somatostatin inhibits glucagon secretion and prevents ketoacidosis in diabetic patients, but has the therapeutic disadvantage of requiring continuous intravenous infusion to exhibit these effects. 2. Consequently, we examined the effect of subcutaneous administration of the long-acting somatostatin analogue octreotide (SMS 201-995) on early ketogenesis in diabetic ketoacidosis. On two separate occasions insulin was withdrawn over a period of 9 h from seven type I diabetic patients. On the second occasion the patients were given 50 micrograms octreotide s.c. before the insulin withdrawal and every 3 h during insulin withdrawal. 3. Differences in integrated free fatty acid responses (4706 +/- 1227 mumol l-1 h vs 3026 +/- 835 mumol l-1 h, AUC, P = NS) were not significant, but the peak increments of acetoacetate (1413 +/- 354 mumol l-1 vs 612 +/- 176 mumol l-1, P less than 0.05), beta-hydroxybutyrate (2180 +/- 475 mumol l-1 vs 922 +/- 246 mumol l-1, P less than 0.01) and the decrements in plasma bicarbonate (-8 +/- 1 mumol l-1 vs -4 +/- 1 mumol l-1, P less than 0.05) and pH (-0.07 +/- 0.01 vs -0.03 +/- 0.01, P less than 0.05) were significantly less with octreotide. 4. At the same time peak increments of glucagon were lower with octreotide treatment (329 +/- 206 pg ml-1 vs 39 +/- 30 pg ml-1, P less than 0.05). 5. We conclude that, despite accelerated lipolysis and provision of substrate for ketogenesis during insulin withdrawal, this somatostatin analogue significantly reduces ketogenesis resulting from insulin deprivation, probably secondary to decreasing glucagon secretion. This drug may be useful in short term prophylactic treatment of diabetic patients during periods of increased risk for ketoacidosis.

Na 1 Nachlass Max Horkheimer, 15 - Korrespondenzen u.a. mit Hans Fried (p. I 8, 1-201)

11 Briefe zwischen Hans Fried und Max Horkheimer, 1938-1940; 1 Brief von Max Horkheimer an die Albert Teachers Agency New York, 21.03.1941; 2 Briefe zwischen dem American Committee for International Studies, Princeton, New York und Max Horkheimer, 11.01.1941, 16.01.1941; 1 Brief von Sullivan & Cromwell New York an Max Horkheimer, 18.03.1940; 12 Briefe zwischen der Columbia University in the City of New York und Max Horkheimer, 1938-1940; 2 Briefe von Hans Fried an die Columbia University in the City of New york, 1938-1939; 1 Brief von Max Horkheimer an das Emergency Committee in Aid of Displaced German Scholars New York; 2 Briefe zwischen der Ittleson Foundation New York und Max Horkheimer, 19.11.1938, 28.11.1938; 1 Brief von Max Goldschmidt an Hans Fried, 21.04.1938; 1 Brief von Max Horkheimer an Max Goldschmidt, 25.04.1938; 2 Briefe von Alice Friedlaender an Max Horkheimer, 1932, 1944; 3 Briefe zwischen Charles S. Friedman und Max Horkheimer, 21.03.1942, 1936, 1942; 4 Briefe von C. J. Friedrich an Max Horkheimer, 1941; 4 Briefe von Franz L. Neumann an C. J. Friedrich, 1941; 8 Briefe zwischen den Friends of Europe London und Max Horkheimer, 1934-1938; 3 Briefe von Max Horkheimer an John W. Fries, 1939; 2 Briefe von Gertrud Fries an Max Horkheimer, 1936; 1 Brief von Josef Fröbes an Max Horkheimer, 24.08.1937; 3 Briefe zwischen Fruin und Max Horkheimer, 1936; 14 Briefe zwischen Eduard Fuchs und Max Horkheimer, 1935-1939;

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 201 - Übermittlung von August Röckel des vom British Association in Aberdeen bestätigten Beweises der Richtigkeit der Farbenlehre Goethes

u.a.: Zitat aus dem englischen Magazin Athenaeum; Experiment zur Farbenlehre; Johann Wolfgang von Goethe; Smith; Isaak Newton;

Ms.Ff.F.Stoltze 3. 201 - Brief von Ernst F. A. Münzenberger an Friedrich Stoltze

Soziale Verhältnisse ("Pauperismus") in Frankfurt, Zu einem "Schützling" Stoltzes

Ausst. 201 - Speculu[m] patie[n]tie cum theologycis consolationibus fratris Ioannis de Tambaco

Vorbesitzer: Heinrich Anton Cornill-d'Orville (Exlibris im Vorderdeckel);

Ms. lat. oct. 201 - El Duende de Palacio

Die im Katalog angegebenen Seitenzahlen weichen von den vorhandenen ab.