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Biomedical subjects

M Görtler

Publications and source records attributed to M Görtler.

4 recordsLinked to original sources

Is there a syndrome of tuberothalamic artery infarction? A case report and critical review.

Short-term post-acute neuropsychological, neurological, and neuroradiological test results and a 16-month follow-up of a 65-year-old patient with a right hemisphere ischemic lesion in the tuberothalamic area of vascular supply are reported. During a 6-week period of examinations the originally left- but trained right-handed patient exhibited fluctuating neuropsychological disorders including aphasia, visuo-perceptive and visuoconstructive disorders, and memory and attention deficits. In the follow-up examination the patient exhibited no aphasia and significant improvements in most neuropsychological tasks. Based on three-dimensional reconstruction of MRI, lesion topography and involvement of thalamic nuclei were established. We discuss the neuropsychological and neurological symptoms of the present case against the background of the 'syndrome of unilateral tuberothalamic artery territory infarction' proposed by Bogousslavsky and coworkers (1986) and the neuropsychological literature on unilateral ischemic anterior/anterolateral thalamic infarction.

Aged↗

Tissue characterisation of atherosclerotic carotid plaques by MRI.

Carotid artery plaques with intraplaque haemorrhage or atheromatous debris have been found to be associated with an increased risk of embolic stroke. Other methods have failed to detect plaque morphology, and it is not clear whether MRI allows differentiation between prognostically and therapeutically relevant plaque types. We examined 17 carotid bifurcation plaques which had been removed in toto by MRI. For quantifying MR signal intensities (I) the contrast-to-noise ratio (CNR) was used: (ITissue-IRef)/SDRef, with normal saline (0.9%) as reference (Ref) and the standard deviation (SD) of the noise. Measurements were correlated with the histopathological appearance of "simple plaques", consisting of fibrous intimal thickening, lipid deposits and/or atheromatous tissue with cholesterol crystals, largely calcified plaques, and "complicated plaques", containing recent intramural haemorrhage or friable atheromatous debris. Significantly different mean CNR could be measured in the three plaque types on T1- and T2-weighted sequences (p < 0.00001) and using the FLASH pulse sequence with a flip angle of 15 degrees (p < 0.001). With the T1-weighted sequence simple plaques showed a CNR of 4.4 +/- 2.3, calcified plaques -4.8 +/- 2.6 and complicated plaques 15.1 +/- 4.3. Using this technique, each single plaque could be correctly classified, an unalterable prerequisite for a clinical application. To date, motion artefacts due to patient movement or insufficiently triggerable vessel pulsation in combination with relative long acquisition times (6-7 min) have limited in vivo investigations. If these problems could be overcome, MRI might become a valuable technique for studying carotid plaque morphology.

Calcinosis↗

Differentiating subtotal carotid artery stenoses from occlusions by colour-coded duplex sonography.

During a 9-month period the carotid arteries of 2420 consecutive patients were investigated by conventional Doppler and duplex ultrasonography as well as by colour-coded duplex sonography. Of 186 internal carotid arteries showing a diameter reduction at the bifurcation level of 95% or more by conventional techniques, 131 underwent X-ray angiography which revealed a subtotal stenosis in 25 and an occlusion in 106 cases. Using a total of ten criteria for describing the colour-coded duplex findings, the "distal colour filling", a combination of three single criteria, could be found in all subtotal stenoses and none of the occlusions. "Distal colour filling" was diagnosed if a colour signal was present for a length of at least 1.5 cm directly behind an assumed stenosis comprising the whole area between the vessel walls. Our results suggest that non-invasive colour-coded duplex sonography is superior to conventional Doppler and duplex techniques and comparable to invasive X-ray angiography in differentiating extracranial subtotal carotid artery stenoses from occlusions.

Arterial Occlusive Diseases↗

Animal experiments with a new dura graft (polytetrafluorethylene)--results.

A comparative animal experiment study on rabbits was performed to test a synthetic dura (expanded polytetrafluorethylene = ePTFE = Gore-Tex Surgical Membrane). For the purpose of comparison with the ePTFE implanted in the left hemisphere, lyophilized natural dura (Lyodura) was used and removed from the subjects after two, eight and twelve weeks. There were no rejection reactions. The lyophilized dura showed pronounced environmental reaction, with cellular permeation and indications of revitalization. The ePTFE manifested only slight reaction and remained inert in an enclosing sheath of connective tissue. The biocompatibility and other properties, such as simple handling and resteriliziability, of ePTFE can thus be assessed as positive.

Animals↗