PubMed Health⌕ Search

Biomedical subjects

M Berkhoff

Publications and source records attributed to M Berkhoff.

14 recordsLinked to original sources
PubMed2005

[Human immunodeficiency virus-associated tuberculous meningoencephalitis causing abnormal behaviour in a prisoner].

Little is known about the type and frequency of psycho-organic syndromes among prisoners. We report the case of a 20-year-old African HIV-I-positive male asylum seeker who developed increasingly bizarre behaviour in prison. The observation of complex behavioural disturbances with a hallucinatory-delusional state led to the diagnosis of delirium caused by AIDS-defining tuberculous meningoencephalitis. The patient improved with specific, symptomatic treatment. This case illustrates the difficulties in diagnosis when communication is impeded. Scrupulous differential diagnosis is necessary for all prisoners manifesting behavioural disturbances. We discuss the pathogenesis and diagnostic procedures of tuberculous meningoencephalitis.

AIDS Dementia Complex↗
PubMed2001

Extensive white-matter changes in case of adult polyglucosan body disease.

Extensive white matter signal changes were observed on T2-weighted images of a 49-year-old man. He presented with a slowly progressive gait disorder, and finally developed severe dementia. Extensive metabolic and infectious investigations failed to disclose the underlying cause during life. Autopsy revealed adult polyglucosan body disease. We discuss MRI findings likely to permit this diagnosis if combined with clinical findings and nerve or skin biopsy.

Ataxia↗
PubMed2000

Postanoxic alpha (theta) coma: a reappraisal of its prognostic significance.

OBJECTIVES: To appraise the controversial prognostic significance of postanoxic alpha or theta coma (ATC). METHODS: We prospectively assessed 14 comatose patients with ATC after cardiac arrest by means of a protocol which included repeated clinical examinations, EEG, and median somatosensory evoked potentials (SEP). Good outcome was defined by the reappearance of cognition (Glasgow outcome scale 3-5) at any time during the 1 year follow-up. RESULTS: Nine of 14 patients had a monotonous, frontally accentuated and a reactive alpha (theta) EEG activity (complete ATC). In these patients ATC was recorded a mean of 47 h after resuscitation, the mean Glasgow coma scale (GCS) was 4 at 48 h, and early cortical SEPs were altered or absent in 5 of 7 patients. All nine patients died. In five of 14 patients the alpha (theta) EEG activity was either not monotonous, partially reactive or posteriorly dominant (incomplete ATC). In these patients ATC was recorded a mean of 43 h after resuscitation, the mean GCS was 8 at 48 h, and early cortical SEP were normal in 4 of 5 patients. Three of 5 patients regained cognition, two of them remained however dependent in activities of everyday life. CONCLUSIONS: This study and a review 283 cases of postanoxic ATC reported in the literature suggest the existence of incomplete and complete variants of postanoxic ATC. Whereas complete ATC is invariably associated with a poor outcome, full recovery is possible in patients with incomplete ATC. The combination of EEG, clinical, and SEP findings improves the prognostic accuracy of postanoxic ATC.

Adult↗
PubMed1998

[X-chromosomal bulbospinal muscular atrophy (Kennedy syndrome)].

Two brothers with slowly progressive weakness and congenital nystagmus are presented. DNA analysis confirmed X-linked recessive bulbospinal muscular atrophy (XBSMA, Kennedy's disease) by demonstration of increased size of a CAG-triplet repeat on the androgen receptor gene on the X-chromosome. XBSMA is characterized by almost symmetrical muscular atrophy, weakness and fasciculations predominantly of bulbar, facial and proximal muscles of the extremities, with onset in the third to fifth decade. Tendon reflexes are depressed and pyramidal signs are absent. Sensory symptoms are clinically rare, but sensory nerve action potentials are frequently abnormal. Additional symptoms are important for differential diagnosis, and include postural tremor, gynecomastia, diabetes mellitus, testicular atrophy and impotence. Differentiation of this hereditary disorder from treatable conditions such as multifocal motor neuropathy or amyotrophic lateral sclerosis is essential. Though life expectancy is normal, patients become disabled in the course of the disease and need supportive care. Periodic testing for diabetes is recommended, and genetic counseling should be provided for patients and their relatives.

Adult↗
PubMed1998

A paradoxical rise of neonatal seizures after treatment with vitamin B6.

We report the case of a newborn with intractable epileptic seizures developing a paradoxical rise of seizure frequency and electroencephalogram alterations after administration of vitamin B6. We have been unable to determine the aetiology of this disorder. In a newborn presenting with drug-resistant epileptic seizures, the first therapeutic option remains the application of intravenous pyridoxine, but the physician should be aware of the risk of an increase in seizure frequency.

Electroencephalography↗
PubMed1998

Developmental background and outcome in patients with nonepileptic versus epileptic seizures: a controlled study.

PURPOSE: This study was designed to evaluate the relevance of developmental emotional stress factors, which are considered to influence emotional functioning, as contributing factors in the development of psychogenic symptoms. METHODS: Ten patients with nonepileptic seizures (non-ESs) (frequently referred to as psychogenic seizures), in whom diagnosis had been confirmed by a placebo-infusion test (PT), and 10 control patients with complex partial seizures (ESs) were evaluated with regard to developmental background by using structured in-depth interviews performed by a single interviewer blinded to the diagnosis. In addition, outcome assessment in the non-ES group after PT was done. RESULTS: There were no significant differences between groups in developmental psychosocial stress or in any single developmental stress factor. Six months after PT, the outcome was favorable in patients with non-ES: six were seizure free, and two had a considerable reduction in frequency of seizures. CONCLUSIONS: Our research indicates the following: (a) a high incidence of developmental stress factors and functional disturbances may be found in patients with non-ESs and ESs; (b) assessment of developmental emotional stress and functional disturbances as a basis for validating the diagnosis of non-ES should be treated with caution; (c) use of PT followed by supportive information about the nonepileptic origin of the attacks may have a positive therapeutic effect or help to introduce psychotherapeutic treatment.

Adult↗
PubMed1997

[Ocular myositis].

We report a young woman presenting with "painful diplopia" caused by inflammation of external eye muscles affecting both eyes sequentially. Orbital MRI disclosed swelling, signal hyperintensity and enhancement of isolated eye muscles. Corticosteroid treatment led to a complete remission within a few days. The compiled data of a literature review enclosing 52 sufficiently documented patients diagnosed as orbital myositis is reported with respect to clinical features, laboratory findings, associated disease, value of imaging procedures (CT,MRI). Therapeutic aspects and differential diagnosis are reviewed.

Adult↗
PubMed1996

[Experiences with the classic nail in management of per-/subtrochanteric femoral fractures in elderly patients].

In the department of trauma and reconstructive surgery at the University Hospital of Hamburg-Eppendorf (UKE) the surgical treatment of unstable per- and subtrochanteric femoral fractures (AO 31A2 and 31A3) in elderly patients with severe osteoporosis includes the implantation of dynamic hip screws (DHS) and gamma nails, as well as the straighter "classic nails". Using 43 short and 15 long classic nails, 58 fractures in seven women and 51 men, respectively, with an average age of 85 years (65-98 years) were stabilized over the last 2 years with good results (98.3% primary full weight bearing). In order to facilitate implantation of the longer nails, additional antetorsion of the femoral neck screw and improvement of the distal interlocking have been developed by the manufacturer.

Aged↗
PubMed1995

[Experiences with plate osteosynthesis in treatment of peri- and sub-prosthetic femoral fractures].

Plate-osteosynthesis proves to be an established procedure in our department for treatment of fractures of the femur in patients older than 70 years with total hip replacement even when loosened. It offers the advantages of comparably low aggressive standard operation techniques and acceptable success rates. This treatment allows for short preoperative period of the patients with their typical multimorbidity in many traumatological departments. In younger patients with symptomatical loosening, simultaneous exchange of the hip prosthesis should always be considered. Thus, individual therapy concept including the specific fracture type, general condition and age must be followed for each patient.

Aged↗
PubMed1989

[Insulin reserve and morphology of the tail of the pancreas following resection of the head of the pancreas using various surgical methods].

Four modifications of dealing surgically with the remaining pancreas after resection of the pancreatic head were compared to each other in dogs. Insulin response and corresponding blood sugar levels were controlled, the remaining pancreas was examined histologically. The obstruction of the pancreatic ducts by prolamine showed mainly sclerosis of the exocrine tissue whereas the duct ligation was followed by atrophy. The free intraperitoneal draining of the duct system showed both alterations, the pancreatojejunostomy did hardly impair the exocrine pancreas. According to the grade of sclerosis of the exocrine tissue, the insulin response was delayed followed by a pathologic glucose tolerance. This was shown particularly for the obstruction of the ducts by prolamine.

Amylases↗
PubMed1988

[Intravenously stimulated insulin reserve of the pancreas following experimental pancreatic duct ligation in the swine--studies 2, 4 and about 60 days following ligation].

After pancreatic duct ligation (PDL) intravenous glucose tolerance tests (i.v. GTT) were performed in 12 pigs. The release of insulin and the corresponding blood sugar levels were controlled, the pancreata were examined histologically and immunohistochemically. In spite of a reduced number of beta-cells no reduction of glucose tolerance could be shown 60 days after PDL. Two days after the i.v. GTT showed an increased release of insulin corresponding with lowered blood sugar levels. This phenomenon is explained as a stimulated state of the beta-cell in the phase of interstitial edema.

Animals↗
PubMed1983

[Accidental finding: the small, differentiated thyroid carcinoma. Report of 46 thyroid carcinomas of up to 15 mm diameter].

Review of 190 cases of thyroid carcinoma between 1974 and 1981 showed an increasing rate of small papillary carcinoma. The study included 46 tumors which did not exceed 15 mm in diameter. Most of these lesions (3/4) were discovered incidentally at thyroid operations of various types. In spite of the early stage of carcinoma 6 tumors were already associated with cervical nodal metastasis, cases showed multiple lesions within the thyroid gland, homolateral and bilateral. With respect to these cases total thyroidectomy and subsequent radium therapy are generally suggested.

Adolescent↗
PubMed1979

[Must cold nodules continue to remain absolute indications for surgery?].

The vast increase in thyroid operations in recent years, resulting partly from the continued development of nuclear diagnostic techniques, has led to the acquisition of new knowledge. Retrospective research on 6252 thyroid operations performed during the last 15 years shows an increase in the number of scintigraphically cold thyroid nodes, both absolutely and in relation to the total number of thyroid operations. With increased use of surgery, the malignancy rate in cases with cold thyroid nodes has fallen to 3.2%; the malignancy rate in cases where scintigraphy gave other results is 1.2%. Favorable developments have occurred in the earlier detection of cancer and in histologic diagnosis. In the 1960s, one-half of malignant goiter cases were first detected in stages III and IV of the TNM scala and could therefore be given only a palliative operation. Today, 80% of cases are detected and treated curatively in stage I. Whereas from 1964 to 1969 almost 50% of malignant goiters were histologically undifferentiated, today 90% are well-differentiated carcinomas. In view of these statistics, use of the scintigraphic diagnosis of cold thyroid nodes as an invariable indication for surgery should be reconsidered.

Adolescent↗