Markakis, Evangelos

[["dc.bibliographiccitation.firstpage","378"],["dc.bibliographiccitation.issue","4"],["dc.bibliographiccitation.journal","Acta Anaesthesiologica Scandinavica"],["dc.bibliographiccitation.lastpage","382"],["dc.bibliographiccitation.volume","44"],["dc.contributor.author","Mursch, K."],["dc.contributor.author","Buhre, W."],["dc.contributor.author","Behnke-Mursch, J."],["dc.contributor.author","Markakis, E."],["dc.date.accessioned","2018-11-07T09:59:01Z"],["dc.date.available","2018-11-07T09:59:01Z"],["dc.date.issued","2000"],["dc.description.abstract","Background: In neurosurgical procedures within brainstem structures, corticosteroids are routinely administered to prevent oedema and to reduce intraoperative trauma, After replacing the routine administration of dexamethasone (DX) by high-dose methylprednisolone (MP) during surgery for tumours within brainstem structures, a decreased incidence of intraoperative haemodynamic instability events was observed. To test this hypothesis, a retrospective analysis was performed. Methods: Peroperative data of 62 surgical procedures of brainstem tumours were retrospectively analysed with respect to haemodynamic instability requiring changes in surgical strategy and/or emergence medication with vasoactive drugs. Severe changes in haemodynamic parameters were defined as a significant increase or decrease in heart rate and/or mean arterial blood pressure greater than 30% compared to baseline values. From 1988 to 1994, intravenous dexamethasone was given peroperatively in 33 patients. After a bolus of 1 mg kg(-1) body weight (BW) 30 min preoperatively, 0.2 mg kg(-1) were given every 4 h. From 1994 until now, methylprednisolone was administered instead of dexamethasone in 29 patients. After an initial bolus of 30 mg kg(-1) BW immediately before surgery, 5.4 mg kg(-1) h(-1) were given 23 h postoperatively. Results: The results of this retrospective analysis suggest that the number of operations with episodes of bradycardia, arterial hypotension (P<0.05), tachycardia and arterial hypertension (P<0.005) was significantly decreased in the group of patients treated with high-dose methylprednisolone. Conclusion: The retrospective analysis of the clinical data showed that the routine use of high-dose methylprednisolone was associated with a decreased incidence of haemodynamic instability in a selected group of patients undergoing brainstem surgery. This finding has to be proven in prospective double-blind controlled studies. (C) Acta Anaesthesiologica Scandinavica 44 (2000)."],["dc.identifier.doi","10.1034/j.1399-6576.2000.440404.x"],["dc.identifier.isi","000086041400004"],["dc.identifier.pmid","10757568"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/37490"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Munksgaard Int Publ Ltd"],["dc.relation.issn","0001-5172"],["dc.title","Peroperative cardiovascular stability during brainstem surgery. The use of high-dose methylprednisolone compared to dexamethasone - A retrospective analysis"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","128"],["dc.bibliographiccitation.issue","2"],["dc.bibliographiccitation.journal","British Journal of Neurosurgery"],["dc.bibliographiccitation.lastpage","136"],["dc.bibliographiccitation.volume","19"],["dc.contributor.author","Mursch, K."],["dc.contributor.author","Halatsch, M. E."],["dc.contributor.author","Markakis, E."],["dc.contributor.author","Behnke-Mursch, J."],["dc.date.accessioned","2018-11-07T11:10:07Z"],["dc.date.available","2018-11-07T11:10:07Z"],["dc.date.issued","2005"],["dc.description.abstract","Intrinsic brainstem tumours in adults have a poor prognosis and surgical resection is rarely performed. Encouraged by successful operations on children performed in our department, we began a more aggressive strategy of open operations. Between 1986 and 1997, we operated upon 16 consecutive patients over 16 years of age (five female, 11 male, mean age 36.9 years) who were suffering from intrinsic tumours located in the pons and/or medulla oblongata. The extent of first open resection was 80 - 100% in two of the cases and more than 50% in nine cases. The mean survival time after the first occurrence of symptoms was 88.1 ( median 34.5) months, and 39.9 ( median 11) months after the first open operation. The rate of 5-year survival from the first occurrence of symptoms was 37.5% (25% after the first open surgical procedure). Thirteen out of 16 patients died within the follow-up period of at least 6.3 years, two of them within the immediate postoperative period. Eleven patients experienced a postoperative deterioration of symptoms from which only four recovered. Eight patients had from WHO grade II astrocytoma and a similar course as patients with higher-grade gliomas (n=4). Our results indicate that open microneurosurgery for intrinsic brainstem tumours is of questionable benefit for the patient. Although surgery offers the advantages of reliable confirmation of histopathology and may be associated with prolonged survival, neurological deterioration was common and, unlike in paediatric patients, often irreversible."],["dc.identifier.doi","10.1080/02688690500145530"],["dc.identifier.isi","000231478700004"],["dc.identifier.pmid","16120515"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/53148"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Taylor & Francis Ltd"],["dc.relation.issn","0268-8697"],["dc.title","Intrinsic brainstem tumours in adults: results of microneurosurgical treatment of 16 consecutive patients"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","299"],["dc.bibliographiccitation.issue","1A"],["dc.bibliographiccitation.journal","Anticancer Research"],["dc.bibliographiccitation.lastpage","304"],["dc.bibliographiccitation.volume","20"],["dc.contributor.author","Ludwig, H.-C."],["dc.contributor.author","Feiz-Erfan, I."],["dc.contributor.author","Bockermann, Volker"],["dc.contributor.author","Behnke-Mursch, J."],["dc.contributor.author","Schallock, K."],["dc.contributor.author","Markakis, E."],["dc.date.accessioned","2018-11-07T11:00:16Z"],["dc.date.available","2018-11-07T11:00:16Z"],["dc.date.issued","2000"],["dc.description.abstract","Background: Nitric oxide (NO) is synthesized from arginine by three different isozymes of nitric oxide synthase (NOS I-III). NO has been identified as a powerful metabolite cf vascular smooth muscle cell function, cerebral blood circulation and oedema induction. NOS induction by different cytokines has been shown previously in glioblastoma cell cultures and NOS III expression due to astrocytoma grading has been shown in several tumors recently. The aim of the present study was to study the coexpression of NOS I-III, macrophage and capillary presence with VEGF, ECF and their receptors and to investigate a possible mechanism in peritumoral oedema generation.. Materials and Methods: We have investigated the expression (4- grade values, blinded assay by two observers) of NOS I-III together with those of VEGF, VEGF-R (Flt-1), EGF-R1, von-Willebrand-factor (VWF) and a pan-macrophage marker (ki-MIP) immunohistochemically in tumor specimens from 220 patients and performed tumor volume morphometry by image analysis in a subgroup of 32 cases to test for any correlation with the peritumoral oedema volumes. Inducible NOS II was further investigated by in situ labelling with a DNA oligonucleotide probe cocktail. Results: All of the specimens revealed some NOS expression, NOS II was expressed in macrophages, microglia and endothelial cells, NOS III and I was localized in glioblastoma cells, NOS III in endothelial cells as well. The highest degrees of expression were observed in 46% (NOS I), 22% (NOS II) and 75% (NOS III) of all specimens, Inducible NOS II in any expression grade was observed in 47.5% of the specimens. Significant correlations were observed for the expression of the macrophage marker Ki-M1P with NOS II (p = 0.024), endothelial NOS III with NOS I (p = 00003), VEGF-R1 with NOS II (p = 0.0008) and NOS III (p = 0.011) The oedema volumes could not be correlated significantly with NOS or VEGF-R1 expression values but with those of endothelial staining (p = 002). We observed a trend towards higher Ki-MIP expression values together with higher oedema volume extensions. In situ hybridization demonstrated reaction products in endothelial and perivascular regions and sometimes scattered throughout the specimens revealing the labelling of macrophages. Conclusions: The main source of NO is NOS I and NOS III The latter is located in endothelial cells and glioblastoma cells. The expression of NOS II in glioblastomas is restricted to infiltrating macrophages. NOS II and III expressions were observed significantly together with that of VEGF-R1. Neither NOS I-III nor VEGF-R expression could be correlated with the extension of the peritumoral oedema."],["dc.identifier.isi","000086326500045"],["dc.identifier.pmid","10769671"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/50886"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Int Inst Anticancer Research"],["dc.relation.issn","0250-7005"],["dc.title","Expression of nitric oxide synthase isozymes (NOS I-III) by immunohistochemistry and DNA in situ hybridization. Correlation with macrophage presence, vascular endothelial growth factor (VEGF) and oedema volumetric data in 220 glioblastomas"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]