Zugl.: Köln, Univ., Diss., 2004

Freie Universiẗat, Diss.--Berlin, 1969. / Literaturverz. S. 212 - 227.

Mannheim, Univ., Diss., 2004.

Intracerebral Haemorrhage (ICH) exhibits the worst mortality and morbidity of any stroke subtype. There are no efficacious treatments for this condition and little improvement in patient outcome has been noted despite advancements in medical science over the previous three decades. Furthermore, current available data is increasingly obsolete as the population suffering the disease burden rapidly ages and develops co-morbidities. It is thought that future therapies for this condition may be able to target neuroinflammatory response triggered by the formation of brain haemorrhage however there is little published evidence that has examined this aspect of ICH pathophysiology. This study therefore examines the current prognosis of a large cohort of patients with ICH to determine the key factors which result in mortality. We find that patients treated at a specialist centre have a surprising and significantly improved survival advantage. Since clinical practice in the United Kindgom is widely influential, the second part of the study focuses on whether the optimal cases are currently being transferred to these centres. The next part of the study then uses MRI/PET brain imaging for the first time in patients with ICH to establish an important link between the processes of neuroinflammation and Blood-Brain-Barrier breakdown. Finally, the concluding part of the thesis presents functional and radiological data from a rat model of ICH in which the inflammatory cascade has been modulated by the use of an antagonist against IL-1. The thesis thus presents a novel and important contribution in our present understanding of the preclinical and clinical disease process.

Zugl.: Hamburg, Univ., Diplomarbeit, u.d.T.: Garbe, Maija Inez ; Knippenberg, Simone: Förderung der Fähigkeit zum Alleinsein, 2004.

Intro/Aims: Differences in end-of-life decision-making among minorities have been well described. However, among Native Hawaiian and Other Pacific Islanders (NHOPIs), this has not been well studied. Aim 1: Determine if differences in time to withdrawal of life support (WOLS) exist between NHOPIs and non-Hispanic whites (NHWs). Aim 2: If differences in time to WOLS between races are found, examine factors that may contribute to these differences. Methods: A retrospective study was conducted on patients admitted to a primary stroke center in Honolulu with diagnosis of spontaneous intracerebral hemorrhage (ICH). Medical records were reviewed for occurrence of WOLS and time of WOLS. Unadjusted and multivariable logistic regression models were performed to determine associations between race and WOLS. Kaplan Meier analysis and Cox regression were performed to estimate survival time to WOLS and to compare these results between racial groups. Results: 396 patients with diagnosis of spontaneous ICH were studied. Mean time to WOLS after ICH was found to be similar between NHWs and NHOPIs (p = .925). Prevalence of WOLS was significantly lower in NHOPIs in univariate analysis (odds ratio [OR] 0.35, 95% confidence interval [CI] 0.15, 0.80) and Kaplan Meier analysis predicted a significant difference in WOLS between NHOPI and NHWs within 30 days of ICH (p =<. 01). However, in multivariate analysis, race was no longer significant when adjusted for age (OR 0.59, 95% CI 0.25, 1.43) and when fully adjusted (OR 0.68, 95% CI 0.20, 2.39). NHOPIs were significantly younger at the time of ICH when compared to NHWs (p =<.001) although ICH severity and presentation such as initial Glasgow Coma Scale, presence of intraventricular hemorrhage and ICH volume were similar (p = .241; p = .604; p = .901, respectively). Conclusions: No difference in mean time to WOLS was noted between NHOPIs and NHW. However, secondary analysis showed WOLS was less prevalent after ICH in the NHOPI population compared to NHWs, although the significance of this finding was attenuated by age. NHOPIs in this population likely had a lower incidence of WOLS due to the fact that they presented with ICH at a significantly younger age, although small sample size also may have resulted in difficulty detecting variances between races.

Zugl.: Hamburg, Univ., Diss., 2001

Inaug. _ Diss.: Philosophisch-historische Fakultät: Basel: 1975. Contient le texte de B. Kimura: "Uber Amae", traduit du japonais et extrait du 4e chapitre de l'ouvrage: "Hito to hito to no aida". _ Bibliogr. p. 105-133. Index.

Inaug.-Diss.--Munich. / Typescript. Vita. Includes bibliographical references (p. 113-122).

Zugl. leicht überarb. Fassung von: Tübingen, Univ., Diss., 2007