Biomedical subjects

F Block

Publications and source records attributed to F Block.

At least 19 recordsLinked to original sources

PubMed2006

[Heated car seats--a potential burn risk for paraplegics].

The comfort of heated car seats has gained popularity worldwide. We present a rare case of severe second- and third-degree burn in the lower back and sacral region of a 42-year-old post-traumatic paraplegic patient while using a heated car seat. The patient was admitted to our burn unit and required several reconstructive surgery procedures. Inadvertent thermal injury is a constant potential hazard for individuals with impaired sensibility such as paraplegics and other neurologically impaired patients. Early education of patients, manufacturers, and health care personnel is of eminent importance to prevent severe burn injuries in this risk population.

Adult↗

PubMed2006

[Disorders of the cerebellopontine angle].

Disorders of the cerebellopontine angle may present by symptoms like vertigo, hearing problems, affection of the trigeminal or facial nerve. Ipsilateral ataxia and contralateral hemiparesis develop in case of a rather large tumor in this region and display an involvement of the cerebellum and/or brainstem. However, some of these typical symptoms are not recognized by the patient. Thus, in case of a suspicion of a disorder of the cerebellopontine angle the relevant functions have to be tested clinically. In addition, electrophysiology can confirm dysfunction of these cranial nerves. Mainstay of the therapy should be the treatment of the underlying cause. Nevertheless, not seldom it is necessary to treat symptoms like vertigo or facial pain.

Cerebellar Diseases↗

PubMed2006

[Clinical picture of spinal tumors].

Spinal tumors may present with symptoms such as pain and motor and sensory deficits. Sphincter dysfunction may also occur. The clinical picture depends upon the size and localization of the tumor in relation to the cross section and the height along the longitudinal axis of the spinal cord. Typical symptoms due to transverse damage of the spinal cord are complete lesion, Brown-Sequard syndrome, a lesion of the central spinal cord, and posterior cord syndrome. Tetraparesis, spastic, or flaccid paraparesis result from lesions at the cervical spine, thoracic spine, or below the first lumbar vertebral body, respectively.

Brown-Sequard Syndrome↗

PubMed2005

[Neurological diseases and pregnancy: what must the family physician heed?].

A woman in child-bearing age could principally contract a neurological disease during a pregnancy. The diseases are differentiated between those that existed before, such as migraines, epilepsy, multiple sclerosis or myasthenia gravis and diseases that have an increased incidence during pregnancy, for example stroke, thrombosis of a sinus, subarachnoid hemorrhage, restless legs syndrome or thoracic outlet syndromes and pregnancy specific diseases. The diagnostics and therapy of these diseases are limited by the pregnancy; contraindications must be observed.

Anticonvulsants↗

PubMed2005

[Severe burn as a consequence of an epileptic seizure while showering].

We report a case of a 17-year-old patient who experienced an epileptic seizure while showering. The patient suffered full-thickness scald injuries involving thorax, abdomen and both arms and legs. The burn, which included 35% of the patient's body surface area, will cause life-long secondary functional and aesthetic deformities. By installing adjustable shower equipment with a maximal temperature limit, this devastating accident could have been prevented.

Accidents, Home↗

PubMed2005

Inflammation in areas of remote changes following focal brain lesion.

Focal brain lesions can lead to metabolic and structural changes in areas distant from but connected to the lesion site. After focal ischemic or excitotoxic lesions of the cortex and/or striatum, secondary changes have been observed in the thalamus, substantia nigra pars reticulata, hippocampus and spinal cord. In all these regions, inflammatory changes characterized by activation of microglia and astrocytes appear. In the thalamus, substantia nigra pars reticulata and hippocampus, an expression of proinflammatory cytokine like tumor necrosis factor-alpha and interleukin-1beta is induced. However, time course of expression and cellular localisation differ between these regions. Neuronal damage has consistently been observed in the thalamus, substantia nigra and spinal cord. It can be present in the hippocampus depending on the procedure of induction of focal cerebral ischemia. This secondary neuronal damage has been linked to antero- and retrograde degeneration. Anterograde degeneration is associated with somewhat later expression of cytokines, which is localised in neurons. In case of retrograde degeneration, the expression of cytokines is earlier and is localised in astrocytes. Pharmacological intervention aiming at reducing expression of tumor necrosis factor-alpha leads to reduction of secondary neuronal damage. These first results suggest that the inflammatory changes in remote areas might be involved in the pathogenesis of secondary neuronal damage.

Animals↗

PubMed2004

Association between inflammation and nigral neuronal damage following striatal excitotoxic lesion.

We examined the expression of TNF-alpha within the substantia nigra pars reticulata (SNR) following intrastriatal injection of quinolinic acid (QA) and studied the effect of rolipram, a TNF-alpha-inhibitor, on the secondary neuronal damage. QA (240 nmol in 1 microl) was injected stereotactically into the striatum of male Wistar rats. After survival of 1, 3 or 10 days, the animals were sacrificed and immunohistochemical staining with an antibody against TNF-alpha was performed. From day 1 to day 10 after striatal QA injection TNF-alpha positive cells were observed within ipsilateral substantia nigra which were neither present on the contralateral side nor in sham-operated controls. Double labeling with antibodies against TNF-alpha and NeuN, keratan sulfate proteoglycan or GFAP displayed a good overlap between TNF-alpha and NeuN, which suggests that TNF-alpha positive cells are neurons. For the pharmacological approach, three groups of QA rats were treated intraperitoneally with either solvent (n=5), the NMDA receptor antagonist MK 801 (4 mg/kg, n=6) or the TNF-alpha inhibitor rolipram (0.3 mg/kg, n=6), which was started 24 h after QA-injection and continued with daily applications for 14 days. The amount of striatal damage did not differ between the three groups. The number of intact neurons within the ipsilateral substantia nigra of the solvent treated group was reduced by approximately 30% compared to the contralateral side. Both MK 801 and rolipram ameliorated this secondary damage and reduced the number of TNF-alpha positive cells. The observed association between expression of TNF-alpha and secondary neuronal damage within the substantia nigra induced by intrastriatal QA application might hint towards an involvement of this cytokine in transneuronal degeneration.

Animals↗

PubMed2004

[Diagnosis of an initial infratentorial central nervous system B-cell lymphoma during prolonged cortisone medication].

We present a patient with primary central nervous system B-cell lymphoma. He had suffered from slowly developing weight loss and presented to us with disorientation, seizures, and a supranuclear gaze disturbance. The patient was dismissed with the primary diagnosis of autoimmune encephalitis of the brainstem and put on oral corticosteroids. Four months later, his health status had deteriorated, and at that time diagnostic methods pointed to a cerebral lymphoma. Stereotactic biopsy with subsequent immunohistochemistry and polymerase chain reaction analysis revealed a highly malignant B-cell lymphoma of the CNS, despite prolonged corticosteroid treatment. The patient was treated with whole brain radiotherapy.

Adrenal Cortex Hormones↗

PubMed2004

[Primary progressive aphasia].

Primary progressive aphasia is a rare disease characterised by slow deterioration of language, which remains the leading symptom whereas other cognitive functions such as memory, orientation, judgement, and visual-spatial skills are relatively spared and mostly not affected until 5 to 7 years after disease onset. Structural imaging displays atrophy of the left temporal region which can also affect the frontal region or both hemispheres. Reduced neuronal activity in the left temporal lobe can be seen using functional imaging even before structural anomalies are detected. Neuropathological examination reveals neuronal cell loss and gliosis in the regions of atrophy which are sometimes accompanied by spongiform changes. T-positive neurons or plaques and neurofibrillary tangles are present in rare cases. A specific therapy is not known. Logopaedic therapy focussed on the main symptoms seems to stabilise linguistic abilities.

Aphasia, Primary Progressive↗

PubMed2003

[Oral anticoagulation in symptomatic intracranial stenoses].

Symptomatic intracranial stenoses display an increased risk for ischemic stroke. Until now, only retrospective studies have demonstrated a positive effect of oral anticoagulation for prevention of further ischemic strokes. However, this therapy is widely used. The aim of the present study was to examine the efficacy and safety of oral anticoagulation for patients with symptomatic intracranial stenoses in clinical practice. Sixty-one patients with the diagnosis of symptomatic intracranial stenosis between 1992 and 1998 and who received oral anticoagulation were interviewed and examined in 2000. Ten patients suffered ischemic strokes (eight TIA, two completed strokes), and a subdural hematoma occurred in one patient. Six patients died during the observation period. In none of these cases was the death related to oral anticoagulation. Eight extracerebral bleedings occurred. An annual rate of 3% per year for ischemic strokes could be calculated. The annual rates for intracerebral and extracerebral bleeding amounted to less than 1% per year and 2.6% per year, respectively. Thus, oral anticoagulation in patients with symptomatic intracranial stenoses seems to be safe. Although the results suggest its efficacy, this cannot be proven due to the small number of patients examined and due to the design of the study.

Administration, Oral↗

PubMed2003

[Periodic surveillance of nosocomial infections in two neurology intensive care units. A valuable tool for quality management in intensive care].

BACKGROUND AND OBJECTIVE: Nosocomial infections are a common problem in intensive care therapy and have relevant influence on morbidity, mortality and associated costs. The aim of this study was to assess data on the epidemiology of nosocomial infections and related risk factors in neurological intensive care patients and to use them for internal quality management. METHODS: Prospective periodic surveillance was performed in the first quarter of the years 1999 and 2000 in two neurology intensive care units. RESULTS: Within the surveillance period, 340 patients with 2443 patient days and a mean length of stay 7,6 days were enrolled. A total of 63 nosocomial infections were identified in 51 patients. In comparison with national reference data, device utilisation rates as well as device-associated nosocomial infection rates were on a higher level. By timely and interpretative feedback of the surveillance data, for the first time the unit-specific nosocomial infection situation was made clear for the ward staff. As a result, different quality management activities like establishment of evidence-based infection control guidelines, continuous surveillance for pneumonia and optimisation of empirical antibiotic therapy were initiated in both units. CONCLUSION: The establishment of periodic surveillance proved to be a valuable tool for the promotion of quality management activities in both intensive care units.

Anti-Bacterial Agents↗

PubMed2003

[Rhabdomyolysis following cerivastatin monotherapy--implications for therapy with HMG-CoA reductase inhibitors].

Cerivastatine was administered as a reversible HMG-CoA reductase inhibitor (statine) to treat hypercholesterolemia until its withdrawal from the market following 52 reports of death due to drug-related rhabdomyolysis and acute renal failure. In most cases, cerivastatine was applied in combination with drugs which influenced the liver metabolism of cerivastatine via cytochromeoxidase P 450 isoenzymes. We report a well-documented case of acute rhabdomyolysis following cerivastatine monotherapy. The diagnosis was confirmed additionally by muscle biopsy.Finally,we give an overview of the current knowledge concerning therapy with HMG-CoA reductase inhibitors,1 year after the withdrawal of cerivastatine from the market.

Acute Disease↗

PubMed2003

[Cerebral contrast medium extravasation after coronary angioplasty].

We report on an 82-year-old woman who suffered a sudden loss of consciousness, right-sided hemiparesis, and aphasia during a coronary angiographic procedure. Computed tomography (CT) of the brain performed immediately revealed an edema and extravascularly localized contrast media in the left hemisphere. Within 6 h, neurological symptoms had disappeared, and a second CT after 48 h revealed normal results. Usually, extravasation of contrast media affects the posterior circulation with cortical blindness. This case demonstrates that contrast media may affect the blood-brain barrier also outside the posterior circulation. If neurological symptoms occur during angiography, contrast media extravasation must be distinguished from embolism or vasospasm induced by the angiographic procedure.

Aged↗

PubMed2003

[Bacterial meningitis as a complication of Fusobacterium necroforum infection in adults].

Fusobacterium necrophorum, an anaerobic, gram-negative rod, belongs to the physiological flora of the oropharynx. It causes Lemierre's syndrome characterized by oropharyngeal infection, septic thrombophlebitis of the neck, in particular of the internal jugular vein, and metastatic abscesses, predominantly in the lungs. Rarely, and mainly in children, it causes meningitis. Here we report the clinical course of a 25-year-old woman with F. necrophorum meningitis. She presented with incomplete, right third nerve palsy. Within a few days, she developed fever, meningism and progressive reduction of vigilance. Cerebrospinal fluid analysis showed typical signs of bacterial meningitis. After the identification of F. necrophorum, the antibiotic treatment was changed to meropenem, which led to continuous improvement of the clinical symptoms. Due to persistent signs of inflammation in the CSF, metronidazole was added to the antibiotic regime. This case report demonstrates that F. necrophorum should always be considered in the diagnostic workup of bacterial meningitis in adults.

Adult↗

PubMed2003

[Glutamate antagonists for treatment of neuropathic pain].

An altered glutamatergic transmission within the central nervous system is supposed to be involved in the generation and propagation of neuropathic pain. Results from experimental studies with animal models of neuropathic pain demonstrate that glutamate antagonists have a positive effect on various parameters. Clinical studies with the NMDA-receptor antagonists ketamine, amantadine, memantine and dextromethorphan and with the antiepileptics gabapentin and lamotrigine, which reduce presynaptic release of glutamate,have been performed. They have shown that most of these substances can reduce neuropathic pain. Important side effects of the NMDA receptor antagonists are hallucination and agitation, whereas tiredness and dizziness are the ones of the antiepileptics. Till now, glutamate antagonists are not drugs of first choice for the treatment of neuropathic pain. However, they are an effective alternative in case the established drugs are not helpful or are not tolerated well.

Amantadine↗

PubMed2003

Tumor necrosis factor-alpha expression in areas of remote degeneration following middle cerebral artery occlusion of the rat.

Remote areas undergoing delayed neuronal degeneration after focal brain ischemia display a preceding glial activation. The expression of proinflammatory cytokines there has not been examined so far. We examined the expression of TNFalpha in the thalamus and the substantia nigra pars reticulata (SNr) 1, 3 and 7 days after transient middle cerebral artery occlusion (MCAO) of the rat. We used antibodies against glial fibrillary acidic protein (GFAP), OX-42, NeuN and tumor necrosis factor-alpha (TNFalpha) for immunohistochemistry/double-immunofluorescent labeling to investigate the time course of glial activation and the cellular localization of TNFalpha. Neuronal degeneration was measured by means of cell counting in Nissl-stained sections. In the ipsilateral thalamus, TNFalpha was upregulated already 1 day after MCAO. Microglia and astroglia were activated after 3 days. A cellular colocalisation of GFAP and TNFalpha was observed. Neuronal degeneration was evident at day 14. In the SNr, TNFalpha expression was enhanced 3 days after MCAO. Microglia was activated after 3 days and astroglia after 7 days. A cellular colocalisation of NeuN and TNFalpha was observed. Neuronal degeneration was evident at day 14. Thus, in both areas, expression of TNFalpha precedes astrogliosis and neuronal degeneration. The different patterns of TNFalpha upregulation of the substantia nigra pars reticulata and the thalamus following middle cerebral artery occlusion may reflect different pathophysiological mechanisms leading to remote neuronal degeneration.

Animals↗

PubMed2002

[Neurologic complications in inflammatory bowel diseases].

Some inflammatory diseases of the gastrointestinal system are associated with neurological symptoms which, in rare cases, may precede the onset of the gastrointestinal manifestation of the disease. Celiac sprue is characterized by an intolerance to the wheat protein gluten. The typical neurological manifestation of celiac sprue is cerebellar ataxia. The ataxia as well as the gastrointestinal symptoms can be treated with a strictly gluten-free diet. The neurological symptoms of Whipple's disease, a disorder caused by gram-positive bacilli, are variable. Typical symptoms of cerebral Whipple's disease include dementia, ophthalmoplegia, movement disorders, and signs of hypothalamic dysfunction. Nowadays, the diagnosis of cerebral Whipple's disease is made by PCR detection of the bacilli in the CSF. Crohn's disease and ulcerative colitis are associated with neurological symptoms to a similar proportion. Various forms of polyneuropathies have been observed. The CNS manifestations of inflammatory bowel diseases include thromboembolic stroke, cerebral venous thrombosis, and cerebral vasculitis.

Brain Diseases↗

PubMed2002

[Von Hippel-Lindau syndrome with spinal, cerebellar, and retinal hemangioblastoma in identical twins].

We report about a case of a 22-year-old women who was admitted because of sudden and painless proximal paraparesis, sensory loss at distal L 1, and bladder dysfunction. In MRI, cystic lesions in the spinal cord were identified at C 1,C 6,T 1,T 6,and T 11 as well as in the cerebellum.A tentative diagnosis of spinal hemangioblastomas was confirmed by spinal angiography and postoperative histology of the symptomatic tumor at T11.Furthermore, retinal hemangioblastomas were detected by fluorescence angiography and treated with laser surgery. Based on the clinical findings,we assumed the diagnosis of von Hippel-Lindau syndrome (vHL).Postoperatively, the paraparesis and sensory deficit improved, but the bladder dysfunction persisted. The patient's identical twin was screened for hemangioblastomas, too, and spinal, retinal, and one cerebellar tumor with a nearly identical location pattern were found. There was no evidence for pancreatic, adrenal, or renal involvement in both twins. The twins were investigated for inactivating mechanisms of the vHL germline mutations using single-strand conformational polymorphism (SSCP) and Southern blotting, but none of the known germline mutations were identified. Because the family history is devoid of vHL disease, spontaneous mutation might be causal for the syndrome in our patients.

Adult↗