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Biomedical subjects

F Ahlhelm

Publications and source records attributed to F Ahlhelm.

28 records · Page 2Linked to original sources
PubMed2003

[Vesiculitis seminalis--a rare diagnosis in case of chronic groin pain].

In this case report we present a male soccer player suffering from chronic groin pain. Exact diagnosis, i. e. seminal vesiculitis, could finally be evaluated by the means of MR Imaging, and so the patient did fully recover after selective antibiotic therapy. In this case musculoskeletal involvement because of visceral pelvic disorders may be caused by synaptic interaction between the somato-sensory and viscero-motoric system due to the close anatomical relationship between the seminal vesicle of the pelvis and the pubic bone with its insertion of the adductor muscles. In case of chronic groin pain in athletes physicians should also be aware of visceral pelvic disorders. For diagnostic evaluation MR Imaging may be of important help.

Abdominal Pain↗
PubMed2002

Time course of the apparent diffusion coefficient after cerebral infarction.

The purpose of this study was to evaluate quantitative apparent diffusion changes in the center of infarction by measurement of the apparent diffusion coefficient (ADC), and to investigate the influence of ischemia on the contralateral hemisphere. By diffusion echo-planar imaging (EPI) 52 patients showing cerebral infarction were studied within 5 h to >12 months after onset of clinical symptoms. Using three diffusion gradient strengths (b1=30 s/mm(2); b2=300 s/mm(2), b3=1100 s/mm(2)) ADC maps were generated. After onset of ischemia, ADC in the center of infarction was lower than in the contralateral regions of human brain. At first ADC declined for approximately 28 h to a minimum of approximately 150x10(-8) cm(2)/s. Then the ADC reincreased and reached a "pseudonormalization" after approximately 5 days. Chronic infarctions did show much higher ADC values (2000x10(-8) cm(2)/s) than unaffected areas. Neither localization nor size of infarctions showed a significant influence on this time course. In the center of infarction diffusion is isotropic. Even brain regions of the contralateral hemisphere are influenced by cerebral ischemia. In these regions ADC is higher than for physiological conditions. The ADC also declines especially for the first 2-3 days after onset of symptoms, also followed by reincrease. The ADC calculation enables determination of the onset of infarction more exactly than is possible using only diffusion-weighted imaging. Diffusion in the center of infarction is isotropic; hence, orientation of the diffusion gradients has no significant influence on sensitivity of measurements. The calculation of the ADC ratio based on data derived from the center of infarction and the contralateral hemisphere seems to be critical because the ADC in the unaffected contralateral hemisphere also changes.

Brain↗
PubMed2002

[Modern diagnosis in acute cerebral infarct. Diffusion weighted imaging and ADC (apparent diffusion coefficient) calculations].

Many different methods have been established for the diagnosis of cerebral stroke. During the acute phase, small infarctions are often not detectable by computer tomography (CT). Diffusion weighted imaging (DWI) is a new tool which enables the detection of cerebral infarction earlier than is possible by CT. By using DWI it is possible to quantify changes in diffusion by calculating the apparent diffusion coefficient (ADC). ADC maps calculated using DWI therefore enable the quantification of the apparent diffusion conditions and allow the determination of the onset of cerebral ischemia. DWI can be used in the evaluation of new therapeutic strategies by controlling and quantifying the effect of new therapeutic agents.

Acute Disease↗
PubMed2002

[Atypical symptoms in carpal tunnel syndrome - treatment and results].

PURPOSE: Additionally to the typical carpal tunnel symptoms, the patients of this study had atypical complaints. Other reasons for these symptoms than those caused by the compression of the median nerve could be excluded using medical examination or imaging techniques. Purpose of this study was to investigate whether decompression of the median nerve may reduce or even abolish the atypical complaints. METHOD: For this prospective study 378 patients with carpal tunnel syndrome were clinically and electroneurographically examined, which was performed before and after (3 months) they underwent surgical decompression of the median nerve. RESULTS: 70 patients (19 % of all patients) with carpal tunnel symptoms suffered from additional atypical symptoms such as cardiac pain, ipsilateral headache as well as neck and shoulder pain. The diagnosis of carpal tunnel syndrome was made using clinical and electroneurographical examination. Carpal tunnel symptoms of all patients disappeared completely after surgery. Respectively, 61 % of those patients with preoperative atypical complaints did also fully recover. CONCLUSION: This study shows that patients with carpal tunnel syndrome may also suffer from atypical complaints. These symptoms have been shown to be associated with the compression of the median nerve. They may be caused by spinal synaptic interaction between sensory and sympathetic/parasympathetic neuronal pathways by somatically-induced reflex responses.

Adult↗
PubMed2001

Rare pseudotumors of the urinary bladder in childhood.

We report two cases of inflammatory pseudotumors of the urinary bladder, one case of a chronic granulomatous pseudotumor (CGT) and one case of a pseudosarcomatous myofibroblastic (fibromyxoid) tumor (PMT). Both tumors resembled malignancies such as rhabdomyosarcomas regarding clinical appearance and imaging findings and represent rare urinary bladder tumors. The imaging findings on unenhanced and contrast-enhanced MRI as well as histological specimen are presented. Final diagnosis was made following elective surgery. Differential diagnosis of urinary bladder tumors as well as the imaging findings of these clinically comparable cases are discussed. Awareness of these benign lesions may prevent patients from inappropriate therapies such as chemotherapy or radiation therapy.

Adolescent↗
PubMed2001

Intra-abdominal tuberculous peritonitis.

We report the case of a 15-year-old boy suffering from progressive dyspnea on exertion and painful abdominal protrusion. Final diagnosis of intra-abdominal tuberculosis (TB), including lymphadenopathy and abdominal abscess formation, was made following elective laparotomy. This type of disease is a rare manifestation of extrapulmonary tuberculosis. The imaging findings in unenhanced and contrast-enhanced MRI and laparoscopic images are presented. Differential diagnosis of abdominal abscess formation and other fungal or bacteriological infections, as well as the imaging findings of this type of lesion, are discussed. This case demonstrates that atypical manifestation of TB may remain unrecognized; thus, awareness of this kind of manifestation of tuberculosis may prevent patients from being subjected to inappropriate therapies.

Abdominal Abscess↗
PubMed2001

[Controlled dynamic weight training in patients with neuromuscular disorders].

The question posed was whether individually adapted, controlled dynamic weight training, in accordance with training principles and methods from sports science, applied for a limited time, can lead to an improvement in the stimulation and release of muscular strength in patients with neuromuscular disorders. The muscles of the pelvic girdle and the lower extremity of 10 patients (5 with dystrophic muscle disease and 5 with neurogenic muscular atrophy) were exercised provisionally for a period of 6 weeks on various weight training machines. The training routine was 3 sessions (TS) per week at an intensity range of 40-60% of the respective best performance for the exercise (One Repetition Maximum; ORM), at 8-12 repetitions/set and 2-4 sets/exercise. Body weight and ORM were determined before, during and after the training period (TP), the different load criteria/TS were documented. It was possible to train the patients in accordance with principles of training known from sports science. Over the entire TP it was possible to increase the load criteria significantly (p < 0.01). The ORM had increased considerably in all exercises after the TP (p < 0.01). The changes in strength lay between 11 and 95%. Correlation analyses demonstrated that the percentage changes in strength correlated significantly (p < 0.01) and positively (r = 0.87) with the training load in terms of quality. No significant changes in development of strength could be ascertained between the two groups of patients (dystrophic versus atrophic). The individually adjusted, controlled dynamic weight training described above, leads to an increase in the stimulation and release of strength and can be conducted according to principles of training science. Applied in clinical rehabilitation, it represents a supplementary form of therapy in the symptomatic treatment of neuromuscular disorders.

Adult↗
PubMedDate not supplied

[Operative treatment of symptomatic nerve root cysts].

AIM OF THE STUDY: Nerve root cysts are often asymptomatic and show a predilective manifestation for the lumbo-sacral spine. Depending on their size and the anatomic relationship to the nerve roots they may cause symptoms such as pain or even neurological deficits. From the therapeutical point of view, different moldalities of intervention are controversially discussed because the clinical importance of this entity is still unclear. There are curative as well as symptomatic therapeutic options. The curative therapy includes surgical excision of the cyst and duraplasty whereas the symptomatic therapy is limited to drainage of the cyst. The purpose of this study was to evaluate the role of surgical excision of the cyst with duraplasty using microsurgical techniques. METHOD: This study included 13 patients who suffered from pain and neurological deficits with myelographically and MRI proven sacral nerve root cysts. All patients underwent surgery for cyst excision plus duraplasty. RESULTS: Clinical symptoms such as pain and sensory deficits significantly improved in all patients postoperatively. 85 % of the patients showed a full recovery from the previously existing radicular pain and motoric as well as sensory deficits. All patients reported a significant improvement of their preoperative loss in muscle strength. CONCLUSION: Surgical excision combined with duraplasty using microsurgical techniques has proven to be the method of choice in the treatment of symptomatic sacral nerve root cysts.

Adolescent↗
PubMedDate not supplied

School sports accidents: analysis of causes, modes, and frequencies.

About 5% of all school children are seriously injured during physical education every year. Because of its influence on children's attitude toward sports and the economic aspects, an evaluation of causes and medical consequences is necessary. In this study, 213 school sports accidents were investigated. Besides diagnosis, the localization of injuries, as well as the duration of the sick leave were documented. Average age of injured students was 13 years. Most of the injured students blamed themselves for the accident. The most common injuries were sprains, contusions, and fractures. Main reasons for the accidents were faults in basic motion training. Playing soccer and basketball were the most frequent reasons for injuries. The upper extremity was more frequently involved than the lower extremity. Sports physicians and teachers should work out a program outlining the individual needs and capabilities of the injured students to reintegrate them into physical education.

Accidents↗