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Biomedical subjects

G Ladurner

Publications and source records attributed to G Ladurner.

At least 37 records · Page 2Linked to original sources
PubMed2000

Imaging the basilar artery by contrast-enhanced color-coded ultrasound.

Conventional transcranial color-coded real-time sonography of the vertebrobasilar system is limited by imaging problems of the distal segment of the basilar artery. Lung-stable contrast-enhancing agents may overcome this problem by enhancing the quality of Doppler signals by as much as 20%. Fourty-two patients underwent sonographic evaluation of the vertebrobasilar system before and after receiving intravenously administered galactose-based contrast-enhancing agent Levovist by transforaminal and transtemporal routes. Imaging quality was classified into five categories depending on the length of visible color-flow by transforaminal approach: 1--no signal, 2--1-9.9 mm, 3--10-19.9 mm, 4--20-29.9 mm, 5--> or = 30 mm. For transtemporal insonation, imaging quality was classified either as no color flow or sufficient color flow of the basilar tip. By unenhanced investigation, average signal length of color flow was 16 +/- 8 mm for transforaminal investigation; application of Levovist improved this value to 26.6 +/- 6 mm. For unenhanced transforminal approach, 4.8% were assigned to category 1, 11.9% to category 2, 54.8% to category 3, 23.8% to category 4 and 4.8% to category 5. After signal enhancement with Levovist, category 1 covered 0%, category 2 2.4%, category 3 7.14%, category 4 59.5% and category 5 30.9% (p < 0.001). Unenhanced transtemporal approach allowed identification of the basilar tip in 78.6% with an average length of 6.3 +/- 2 mm; contrast enhancement improved this values to 92.9% and 8.3 +/- 3.3 mm respectively (p < 0.05). The application of transpulmonary contrast-enhancing agents improves the reliability of transcranial color-coded duplex sonography of the basilar artery.

Adolescent↗
PubMed2000

Lateralized cognitive visuospatial processing: is it primarily gender-related or due to quality of performance? A HMPAO-SPECT study.

The brain activity of 13 right-handed students (6 men and 7 women) was determined using high resolution (99m)Tc-HMPAO brain SPECT images during visuospatial tasks. The results showed that there was no significant gender-specific difference in solving the visuospatial tasks and that no meaningful statistical difference in brain activity between the two sexes could be found. When the sample was split into groups of good and poor performers, the results showed that there was a relatively symmetrical brain activity both frontal and parietal in subjects with poor test results. The results for those who performed the tests well, on the other hand, showed increased left frontal and right parietal brain activity. These results would suggest an asymmetric type of processing for better visuospatial brain performance independent of gender.

Adult↗
PubMed2000

[Blood lipids and adaptation to stress as risk factors for stroke prevention].

Do stroke prevention patients with increased blood-fat-protein compounds (total cholesterol, HDL- and LDL cholesterol and triglyceride) have a different method of coping than patients with normal blood fat? 1159 stroke prevention patients participated in the following stroke risk investigations at this hospital: biographical and risk factor-orientated anamnesis, a neurological status investigation, a laboratory investigation, a sonographic investigation and a psychological investigation. The differences in the coping strategies of those patients with normal and those with higher blood-fat-protein compounds were investigated. Patients with higher total cholesterol showed significantly higher values in the avoidance of stress situations (sig. 0.041) and a stronger tendency towards escapist behaviour (sig. 0.05). Patients with normal HDL cholesterol values indicated a tendency (sig. 0.07) to higher values in positive self-instruction in comparison to patients with reduced HDL cholesterol values. Those prevention patients with higher LDL values showed a tendency (sig. 0.08) to higher values in the intake of narcotic substances (nicotine, alcohol, tranquillisers, pharmaceutical agents). Patients with increased triglyceride indicated significantly higher values in coping by compensation (eating, shopping, reward behaviour, watching TV; sig. 0.037) and the intake of narcotic substances (sig. 0.044). Prevention patients with higher total cholesterol, LDL/HDL, or triglyceride values showed significantly different coping strategies in comparison to those patients with normal values. Increased avoidance and escapism behaviour and also compensation and the abuse of narcotic substances could be seen in connection with an increase in the risk of a stroke. In contrast, a constructive coping strategy such as positive self-instruction could reduce the risk of a stroke, which goes along with normal HDL cholesterol.

Adaptation, Psychological↗
PubMed1999

[Prevention of stroke].

Stroke is an extremely frequent disorder and represents the third most frequent cause of death in industrial countries. It is associated with catastrophic sequelae not only for the patient but also for his family members, and imposes an enormous socioeconomic burden. The efficacy of treatment of modifiable risk factors in secondary prevention of stroke is beyond any doubt. Based on these experiences, a corresponding strategy for an efficient, economic, and low-risk primary prevention of stroke can be deduced, the efficacy of which again can not be seriously doubted.

Austria↗
PubMed1999

Clinical and EEG findings in complex partial status epilepticus with tiagabine.

A case of complex partial status epilepticus (CPSE) with high dose treatment of tiagabine (TGB) is reported. Seizure aggravation and CPSE developed after stepwise increase of TGB to a dose of 60 mg per day as add-on treatment to carbamazepine (CBZ) 1200 mg/day and vigabatrine (VGB) 1000 mg/day. The EEG during CPSE showed bilateral rhythmic slow activity. Clinical symptoms of CPSE and the EEG normalized after i.v. treatment with clonazepam. The literature and the possible mechanism of this paradoxical phenomenon are discussed.

Adult↗
PubMed1999

[Scuba diving as a rehabilitation approach in paraplegia].

In a group of nine paraplegics a significant increase of pulmonary vital capacity could be shown after participating in a two weeks Scuba (self containing underwater breathing apparatus) diving training. During dives and for a certain time afterwards, a satisfyingly sensed reduction of painful muscle spasms occurred. A comparable group of sailing paraplegics did not show any significant changes within the same time. Because of strict ability criteria combined with an enormous effort of care to meet all security precautions this approach to neurorehabilitation can be offered to a limited number of patients only.

Adult↗
PubMed1998

Clinical relevance of 201Tl-chloride SPET in the differential diagnosis of brain tumours.

Magnetic resonance imaging (MRI) and computed tomography (CT) may not be reliable in the differential diagnosis of tumour necrosis, scar and recurrent tumour. We compared 201Tl-chloride SPET with CT and MRI for the differential diagnosis of these cerebral lesions. Brain SPET was performed in 40 patients after the intravenous injection of 201Tl-chloride. All 40 patients also had a CT or MRI scan, and a histological diagnosis was available for 27 of the patients. For each patient, the ratio of counts in the lesion region of interest (ROI) to counts in the contralateral ROI was calculated and found to be between 0.58 and 9.60. The ratios for high-grade gliomas, metastases and meningiomas were high (> 2.7), especially in tumours with good vascularization. A low ratio (< 1.7) was noted in patients with low-grade astrocytoma, necrosis or ischaemic lesions. There were two exceptional cases of ischaemic lesions in the luxury perfusion stage (ratios of 3.61 and 3.87), as verified by HMPAO-SPET. We found that 201Tl-chloride SPET helps to differentiate between malignant tumours, poorly vascularized benign lesions and necrosis. Differentiation between low-grade astrocytoma and non-malignant lesions was not possible, but there was a trend towards differentiating between low-grade astrocytoma and ischaemic infarction. The timing of the investigation is important to avoid false-positive results in hyperperfused ischaemic tissue.

Adult↗
PubMed1997

SPET investigations in extrapyramidal diseases using specific ligands.

Single photon emission tomographic investigations of the extrapyramidal system have become easier to perform since the development of the ligands [123I]-beta-CIT and [123I]-IBZM. Thirty-three patients were investigated with [123I]-IBZM. The images were evaluated visually and semi-quantitatively (ratio of the striatum to front cortex). Ten controls showed a mean (+/- S.D.) ratio of 1.513 +/- 0.06; nine patients with Parkinson's disease had a smaller ratio of 1.425 +/- 0.095; six patients with Huntington's disease had a significantly lower ratio (1.147 +/- 0.105). Eight patients were not classified, because of different nosologic entities. Twenty-three patients were investigated with [123I]-beta-CIT. They were evaluated using standard techniques and the ratio of the striatum to cerebellum. Six controls had a mean ratio of 5.128 +/- 0.787. In 11 Parkinson patients, the ratio was significantly less (3.359 +/- 0.769). Patients with focal dystonia showed normal values. One patient with Huntington's disease had a significantly lower ratio. Receptor studies of the extrapyramidal system may help with diagnoses and could be of relevance therapeutically.

Adult↗
PubMed1997

Clinical and diagnostic findings in a patient with Creutzfeldt-Jakob disease (type Heidenhain).

A 61-year-old woman had Creutzfeldt-Jakob disease, type Heidenhain, that progressed for 4 months until death, 3 of which she spent in a hospital. The diagnosis was verified by autopsy. Consecutive brain computed tomography, magnetic resonance imaging, blood flow measurements, electroencephalography (EEG), and routine laboratory tests were performed. All imaging techniques showed nonspecific pathological changes, whereas EEG revealed alterations indicative for Creutzfeldt-Jakob disease.

Brain↗
PubMed1995

Diffuse Lewy body disease as substrate of primary lateral sclerosis.

We describe the case of a 40-year-old male patient who had presented clinically as primary lateral sclerosis for the past 10 years and neuropathologically as diffuse Lewy body disease (DLBD). Neuropathology demonstrated DLBD as an almost ubiquitous disorder of the neuronal cytoskeleton.

Adult↗
PubMed1995

Thrombolytic treatment for acute occlusion of the basilar artery.

Sixteen patients with acute occlusion of the basilar artery were treated with systemic fibrinolysis. Recanalisation was achieved in 10 patients; five patients survived and 11 patients died. Survival was associated with vascular recanalisation in every case. Most of the survivors were younger than 50. An age above 50 and a comatose state on admission seem to indicate a poor clinical outcome. The problem of multimorbidity in the older age group also affects outcome adversely. Haemorrhagic complications were found in two cases (12.5%), with clinical deterioration in one.

Adult↗
PubMed1994

[Magnetic resonance tomography and skeletal scintigraphy in spondylodiscitis].

12 patients were diagnosed as suffering from spondylodiscitis by means of clinical and laboratory investigations. Magnetic resonance tomography (MRT) and bone scintigraphy (with Tc 99m-diphosphonate) were performed and 6 patients had further MRT follow up investigations. In the initial state of disease the comparison of MRT and bone scan both revealed a sensitivity of 92%. The specificity was 83% for MRT and 50% for bone scintigraphy, respectively. Therefore we conclude MRT is a more specific diagnostic tool in patients with spondylodiscitis. 6 patients were followed up with additional 13 MRT scans. During the first two months of treatment period in most of the patients more distinct pathological findings were seen in MRT in comparison with MRT at the start. No signs of any improvement despite effective treatment were found in the first three months of therapy.

Adolescent↗
PubMed1993

[The diagnostic value of nuclear magnetic resonance tomography, multimodal evoked potentials and cerebrospinal fluid examination in multiple sclerosis].

Seventy patients with multiple sclerosis (according to Poser's criteria) were clinically assessed and examined with MRI, multimodal evoked potentials (VEP, AEP, SSEP) and CSF analysis (transformed lymphocytes, IgG-Index, oligoclonal banding). In relation to the clinical criteria of McAlpine 40 patients had possible, 16 patients probable and 14 patients definite MS. 81% of the patients (73% possible MS, 94% probable MS, 93% definite MS) had multiple white matter lesions detected by MRI, 79% (78% possible MS, 94% probable MS, 64% definite MS) had an abnormal CSF profile and 67% (60% possible MS, 75% probable MS, 79% definite MS) abnormal results in multimodal EP testing. Of the patients who experienced only one attack (n = 40) 78% had multiple lesions on MRI, 88% had abnormal CSF-findings and 60% had pathologic EPs. Patients with two or more attacks showed in 87% multiple lesions on MRI, in 77% abnormal EPs and in 70% abnormal CSF findings. The number of abnormal MRI and EPs increases with the duration of the disease. 13 patients with a normal MRI were discussed separately. MRI is the most sensitive method in detecting the spatial pattern of disseminated lesions. To monitor the dissemination over time a careful clinical follow-up is still mandatory.

Adolescent↗
PubMed1992

[Immediate and late results following endarterectomy of the carotid bifurcation].

In a retrospective study we analysed two groups each consisting of 100 consecutive patients of similar age and sex distribution who underwent surgery for carotid disease with an intervening period of 5 years (group A 1980/82, group B 1986/87) between the collectives. Against a background of changing indications, tactics and techniques the aim of the study was to detect any differences between the two groups. Group A had a higher proportion of coronary and peripheral vascular disease. The states of cerebral ischemia I, II and III were distributed equally, but state IV was seen more frequently in group B (p less than 0.05). The number of shunt/without shunt operations in group A was 97/2, in group B 10/84 (p less than 0.005). The external carotid artery was deobliterated in 58/81 cases group A versus group B (p less than 0.005). We closed the artery by direct suture in 8/31 (p less than 0.005), by autologous venous patch in 53/26 (p less than 0.005) and by Dacron patches in 39/41 patients. In group A the operative mortality was zero and in group B 1 patient died; one patient in group B developed sudden occlusion (with TIA) postoperatively. Transient intra-/postoperative neurological deficits occurred in 1/2, permanent in 4/2 patients (n.s.). 54/25 patients have died up to 31/08/91. Coronary heart disease was the main cause of late complications and deaths in group A (p less than 0.025). Statistically, there was no dependence of neurological deficits on group, sex, age or intraoperative management. Only patients with preoperative PRINDS hat a higher postoperative neurological deficit rate than the others.

Adult↗
PubMed1992

[P300 and dementia: diagnostic relevance II].

Recent research on the relationship between ERP-latencies and reduced information process capabilities with demented subjects has yielded divergent results. In the present study P300-latencies and RT are used in an attempt to differentiate between demented and nondemented subjects. Based on the "feature-integration-theory" of Treisman an experiment was designed in order to investigate more complex cognitive processes. The results showed that both P300-latency and RT may be used as additional diagnostic indices for cognitive capability.

Adult↗
PubMed1991

[Therapy of organic brain syndrome with nicergoline given once a day].

In a double-blind, active-controlled study 30 patients with mild to moderate multiinfarct dementia diagnosed according to DSM III definition were treated by either 20 mg nicergoline or 4.5 mg co-dergocrine mesilate once daily during eight weeks. Therapeutic effects on symptoms of the organic brain syndrome were quantitatively measured by standardized psychological and psychometric methods evaluating cognitive and thymopsychic functions. Main criteria, which were tested by inferential analysis, were SCAG total score (Sandoz Clinical Assessment Geriatric Scale), SCAG overall impression and the AD Test (alphabetischer Durchstreichtest). Other results were assessed by descriptive statistics. Both treatments resulted in a statistically significant improvement in most of the tested functions. The effects of 4.5 mg co-dergocrine mesilate s.i.d. were in accordance with published results. Although differing slightly with respect to individual results 20 mg of nicergoline once daily showed the same efficacy on the whole.

Aged↗