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Biomedical subjects

G Huffmann

Publications and source records attributed to G Huffmann.

At least 19 recordsLinked to original sources

Chemokines in the cerebrospinal fluid of patients with meningitis.

Meningitis is accompanied by a differential immigration of leukocytes into the subarachnoid space. Since the mechanisms regulating leukocyte invasion are still incompletely understood, we studied the release of the neutrophil-attracting alpha-chemokines IL-8 and GRO-alpha and the mononuclear cell-attracting beta-chemokines MCP-1, MIP-1alpha, and RANTES during meningitis. In 48 paired CSF and serum samples from patients hospitalized for meningitic symptoms, high levels of IL-8, GRO-alpha, and MCP-1 were detected in the CSF during bacterial and abacterial meningitis. Elevated chemokine levels were not found in the blood serum samples taken in parallel. The release of MIP-1alpha or RANTES was below detection limits. The IL-8 and GRO-alpha levels significantly correlated with the number of immigrated granulocytes in the CSF of patients with bacterial meningitis. A similar correlation was found when MCP-1 levels and the mononuclear cell count were analyzed in abacterial meningitis. These findings suggest that the local production of the alpha-chemokines IL-8 and GRO-alpha and of the beta-chemokine MCP-1 represents the major chemoattractant stimulus for the differential recruitment of leukocytes into the subarachnoid space during meningitis.

Adolescent↗

[Cerebral infarct in the circulatory area of the arteria cerebri media following chiropractic therapy of the cervical spine].

Chiropractic manipulation of the neck can occasionally cause severe neurological complications, as demonstrated by this case report. A 59-year-old man who had previously sustained a cardiac infarction and a femoral-popliteal bypass operation, suffered from painful spasms of the cervical muscles for several weeks. After chiropractic manipulation, a left, predominantly brachiofacial, hemiparesis developed during the subsequent 24 hours. Computed tomography demonstrated a recent infarction in the area supplied by the ascending central and parietal branches of the right medial cerebral artery. Doppler sonography revealed occlusion of the right internal carotid artery as the cause. Marked improvement followed hypervolaemic haemodilution daily with 500 ml hydroxyethyl starch and intensive physiotherapy. Blood flow through the internal carotid artery was restored after seven days (demonstrated by Doppler ultrasound). In the presence of arteriosclerotic vessel changes particular care should be exercised in deciding on and execution of chiropractic manipulations.

Brain↗

[Neurologic and psychiatric manifestations of lead poisoning in adults (case report and review of the literature)].

A 59-year-old potter presented with lead polyneuropathy after 37 years of occupational exposure. There was a 25-year history of normochromic normocytic anaemia with moderate basophilic stippling, mild renal failure, hyperuricaemia and abnormal porphyrins. Since 1964 three short psychotic episodes were noted. Cranial computed tomography showed extensive bilateral symmetrical calcification in the cerebellar hemispheres and slight calcification in the subcortical area of the cerebral hemispheres and basal ganglia. T2-weighted magnetic resonance imaging disclosed high signal intensities in the periventricular white matter, basal ganglia, insula, posterior thalamus and pons. Differential diagnostic aspects are discussed with special regard to CT and MRI findings. A review of the literature on neurological and psychiatric manifestations of lead intoxication in adults is given.

Brain↗

[Exercise-induced partial damage of the n. peroneus profundus].

Over a period of two years a 26-year-old man active in sports developed progressively more marked pain in the area of the left lateral tibial edge and signs of foot flexor paresis after physical exertion. These symptoms lasted for several hours. Finally there also developed sensory dysfunction in the area of the deep peroneal nerve. Electrophysiological tests revealed normal peroneal nerve conduction velocity but denervation signs in the anterior tibial muscle. In view of the diagnosis of an exercise-induced incomplete chronic anterior tibial syndrome a fasciotomy was performed revealing connective-tissue thickening of the fascial compartment which was clearly compressed. The sensory disorder in the left foot regressed within a few weeks and the patient has been symptom-free since.

Adult↗

[The so-called turnip-harvester palsy--a rare differential diagnosis today].

This is a report on a student of biology of 25 years of age who presented with left-sided pareses in the innervated area of the n. peronaeus communis after having remained in a squatting position for several hours for withdrawing and processing water samples. Aspects of differential diagnosis are discussed with particular reference to the so-called turnip-harvester's pressure palsy syndrome, a neuropathy triggered by occupational stress caused by out-dated plucking or digup methods for beets and potatoes. This syndrome is now rare, and the authors deliberate on its etiology.

Agricultural Workers' Diseases↗

The treatment of delirium tremens and of incomplete alcoholic delirium--a brief history.

Following the introduction of chlormethiazole for the treatment of delirium tremens a striking reduction in the death rate occurred. The mortality range in most statistics is 1-4%. The patient's age and complications concerning various internal organs affect the clinical outcome and so does the time at which chlormethiazole treatment is initiated. However, this has given rise to the habit of prescribing chlormethiazole at the slightest suspicion of the early stages of delirium tremens. In some cases the use of the drug was no doubt unnecessary, but equally certainly this measure has often prevented the development of complete delirium tremens which is now seen far more rarely than it was 20 years ago. The availability of this well-tolerated and easily controllable drug has made the treatment of most cases of delirium tremens a manageable task for any reasonably experienced physician. However, it should never be forgotten that delirium tremens is a life-threatening condition with many potential complications. Therefore, the initiation of any chlormethiazole therapy calls for careful monitoring by the physician.

Administration, Oral↗

[Prognosis and therapy of peripheral facial nerve paralysis. Electrodiagnostic ways of evaluation].

The function of the facial nerve can be examined by four electrodiagnostic methods. In the nerve excitability test and electroneurography with determination of the distal latency the facial nerve is stimulated over the stylomastoid foramen. Chronaximetry and electromyography are performed in the muscles. Whereas chronaximetry renders an impression of the severity of neural lesion, electromyography can also determine the onset of reinnervation activity. Early prognosis within 6 days of onset can be determined only by nerve excitability test and electroneurography, preferred by us, which assesses the muscle potential. If the potential amplitude decreases more than 35% within two days and the muscle potential disappears between the fourth and sixth day, total degeneration of the nerve with poor prognosis is indicated. Such data can be gathered by at least two electrodiagnostic investigations preferably on the third day after onset and one to three days later. The cosmetic disfigurement through peripheral facial nerve palsy poses immediately the question of prognosis and of the therapeutic possibilities. Usually, this question can be answered by clinical examination alone. As soon as paralysis of facial muscles exists, prognostical statements can be made by electrodiagnostical methods alone. Because of the possiblility of operative treatment it is necessary to assess the infavorable courses early.

Action Potentials↗

[Neurologic syndromes affecting the shoulder (author's transl)].

A number of locally defined as well as generalised diseases of the peripheral nervous system is manifested in the shoulderarm region besides lesions of individual nerves through traumas or as a result of pressure. Radicular syndromes are particularly frequent. These are based on prolapsed disks or degenerative changes of the cervical vertebral column. We must differentiate between these syndromes and the often rather unknown neuralgic amytrophy of the shoulder. Our experience has shown that in too many cases, paralysis of the plexus cervico-brachialis is assumed, although this occurs almost exclusively on the basis of traumatic violence, much rarer due to pressure. In such cases, the physician should look for the scalenus syndrome, the costoclavicular syndrome, and the hyperabduction syndrome. As a rule, pain is the most prominent symptom in plexus pareses through new growths, eg Pancoast's tumour. In such cases, a clear distinction must be made against bursitis of the shoulder (periarthritis humeroscapularis), in which there are no neurogenic changes, but only myogenic changes manifested in the electromyogram. If the sudden pain is accompanied by swelling and weakness of the arm, there is every likelihood of the existence of Paget-von Schrötter's syndrome. A remarkably painless deformation of the shoulder joint should also suggest neurogenic arthropathy in syringomyelia. The physician should also consider disturbances of distant origin, for example in the region of the carpal tunnel, with pain radiating to the shoulder in the manner of brachialgia paraesthetica. Finally, any noticeable weakness or muscular atrophy in the shoulder region should suggest a disease of the neuromuscular system, mainly progressive muscular dystrophy or the rare shoulder girdle type of amyotrophic lateral sclerosis.

Arthropathy, Neurogenic↗