Rest perfusion of coiled aneurysms detected by transcranial color-coded duplex sonography: initial results.
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Adult↗
Biomedical subjects
A Lindner
Publications and source records attributed to A Lindner.
[Postpartum obturator nerve syndrome: case report and review of the nerve compression syndrome during pregnancy and delivery].
Compression of a peripheral nerve or nerve trunk can occur during pregnancy and delivery. The injury may be caused by the fetal head, the application of forceps, trauma or hematoma due to cesarean section, or improper positioning in leg holders. Often, no cause of the injury is found. The most common nerve compression syndromes during pregnancy and delivery are carpal tunnel syndrome, femoral neuropathy, and post partal foot drop. Obturator neuropathy, meralgia paraesthetica, tarsal tunnel syndrome, and syndrome of the rectus abdominis muscle occur less frequently. Symptoms, such as paraesthesia, pain and palsies not always attract the immediate attention of the physician. Sometimes they are misinterpreted as nervous complaints. Often, remission is reached at delivery. A case of obturator neuropathy after delivery is reported, and literature on clinical, pathophysiological and electrophysiological findings in maternal obstetric palsies is reviewed.
Adult↗
Postejaculation serum prostate-specific antigen level.
OBJECTIVE: This study was carried out to determine whether ejaculation may modify the serum prostate-specific antigen (PSA) level and to investigate whether postejaculation serum PSA may play a role in male hypofertility work-up. METHODS: Serum PSA concentration was determined before and 1 h after ejaculation in 18 healthy men (group A) and in 16 men with male-factor infertility (group B). PSA change (delta) was recorded and analyzed. RESULTS: Postejaculation serum PSA differed significantly from basal levels (p = 0.0037 by the Wilcoxon signed rank test). Following ejaculation, a rise was noticed in 74% of subjects. The median relative change in PSA concentration was 54%. No difference in respect to mean, median and relative change was observed between study groups. In two cases (6%), PSA rose from normal level to more than 4 ng/ml. CONCLUSION: A significant postejaculation serum PSA elevation does occur, it is thus recommended that men abstain from ejaculation for 24 h prior to PSA sampling. Postejaculation PSA was not found to significantly correlate with hypofertility.
Adult↗
Clinical, morphological, biochemical, and neuroradiological features of mitochondrial encephalomyopathies. Presentation of 19 patients.
Nineteen patients (9 females, 10 males) with mitochondrial encephalomyopathies (ME) were studied. The diagnosis was established according to clinical and histopathological criteria. Leading clinical features were chronic progressive external ophthalmoplegia (CPEO) and muscle weakness in 95% of the patients. Pigmentary retinopathy was seen in 63%, and was always associated with CPEO. Hypacusis was present in 47% and cerebellar ataxia in 63% of patients. Clinical or electrophysiological signs of involvement of the central nervous system (CNS) were found in 21% of the patients. In muscle biopsy ragged red fibers were the predominant histopathological findings (100% of the patients), while COX-negative fibers were seen in 74%, deletions of the mitochondrial DNA in 42%, and defects of the respiratory chain in 32% of the patients. Increased blood lactate levels were found in 79% of the patients. Needle electromyography revealed myopathic features in 74%, features of denervation in 16%, and was normal in the remainder. Imaging studies showed cerebral atrophy in 58%, cerebellar atrophy in 16%, and hyperintense lesions of the white matter, pyramidal tract or extrapyramidal system in 16% of the cases. It is concluded that the clinical manifestations of ME can be very variable. Diagnosis of ME should be always considered in young patients presenting with CPEO and muscle weakness. In most cases, diagnosis can be made by a few selected investigations, while detection of genetic abnormalities may lead to the diagnosis in the remaining cases.
Adult↗
Time course of high-intensity transient signals in patients undergoing elective heart valve replacement: a prospective study.
BACKGROUND AND AIMS OF THE STUDY: This study was performed to evaluate the time course of intracranial high-intensity transient signals (HITS) in patients undergoing elective heart valve replacement. METHODS: Thirty-three patients were enrolled in this study. The examination protocol included serial (before and at one, five, 90 and 180 days after surgery) monitoring sessions with transcranial Doppler and detailed neurological examination. Monitoring was performed bilaterally over the middle cerebral arteries for one hour per session using 2 MHz probes. Microembolic signals were recognized according to standard criteria and stored on a computer for later evaluation. RESULTS: HITS prevalence increased from 3% preoperatively to 41% on the first postoperative day and remained unchanged during the postoperative period. No influence of the intensity of anticoagulation or valve type on HITS counts was evident. Unilateral monitoring provided adequate results in 83.9% of cases. CONCLUSIONS: The causative role of the valve implant in the pathogenesis of HITS appears certain, since their prevalence dramatically increases following valve implantation. Valve type, duration of valve implant or intensity of anticoagulation did not influence HITS counts. Bilateral monitoring is warranted for accurate evaluation of HITS counts in this patient group.
Aortic Valve↗
Autonomic neuropathy in a patient with adrenomyeloneuropathy.
Adrenomyeloneuropathy (AMN) is a clinical subtype of X-linked adrenoleukodystrophy (ALD). In ALD, the accumulation of very long chain fatty acids (VLCFA) in the nervous system, adrenal cortex, and testes due to impaired degradation of VLCFA is thought to be pathogenic. Demonstration of abnormally high levels of saturated VLCFA is diagnostic of ALD. The symptoms of AMN include spastic paraparesis, impaired vibration sense in the distal legs, urinary disturbances, and mild peripheral neuropathy. About further involvement of the autonomic nervous system, no data are available. We report an AMN patient with clinically suspected and electrophysiologically verified autonomic neuropathy, supporting the hypothesis that neuropathy in AMN is at least partially caused by primary axonal degeneration.
Adrenoleukodystrophy↗
Acute renal failure.
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Acute Kidney Injury↗
Use of the relationship between blood lactate and running speed to determine the exercise intensity of horses.
Eight thoroughbred horses, trained for racing competition, were subjected to a standardised incremental speed test to determine the relationship between their blood lactate concentrations and running speed. Between 14 days before and 14 days after completing the standardised exercise test, the horses were timed for runs of 2000 to 6000 m. The blood lactate concentration after each run was measured and compared with the blood lactate concentration predicted from the individual horse's blood lactate-running speed relationship curve determined from the standardised exercise test. The relationship between the predicted and measured lactate concentrations was evaluated by linear regression. For 42 exercise runs there was a significant positive correlation between the measured and the predicted lactate concentrations and a significant regression: measured lactate (mmol/litre) = 1.01 predicted lactate (mmol/litre) -0.36 (r2 = 0.79, standard error of estimate 0-63 mmol/litre, P < 0.001). It was concluded that the standardised exercise test was a useful technique for predicting the blood lactate concentrations of horses after field exercise.
Animals↗
[Transrectal ultrasound-controlled needle aspiration of a prostatic cyst].
Prostatic cysts are common and are usually acquired and asymptomatic. Congenital prostatic cysts, which may originate from the wolffian system or from remnants of the Muellerian duct, are rare and may cause obstructive symptoms in young adults. Due to the availability of transrectal ultrasonography an increased number of cases of prostatic cysts are being diagnosed. We report a 36-year-old man with a congenital prostatic cyst which caused increasing pain during ejaculation and decreased the force of the urinary stream. It was diagnosed by ultrasonography and treated successfully by ultrasound-controlled, transrectal needle aspiration. There was immediate, complete disappearance of symptoms and no complications.
Adult↗
Meningeal hyperperfusion visualized by MRI in a patient with visual hallucinations and migraine.
A 41-year-old patient with a history of migraine but with no history of seizures had intermittent prolonged and variable complex visual hallucinations and illusions lasting 9 days, accompanied by unilateral headache. Electroencephalography during these visual symptoms revealed occipital epileptic discharges. Distinction between focal migrainous attacks and ictal phenomena was difficult. Magnetic resonance imaging showed a lesion in the right visual cortex probably related to low perfusion and hyperemia of meningeal vessels, representing the rarely described transient MRI changes associated with migraine. Continued treatment with antiepileptic drugs and calcium-channel blocking agents completely resolved the headache and visual symptoms, while minor EEG changes persisted. After discontinuation of treatment, a second attack occurred with a similar and reversible pattern on EEG.
Adult↗
Diffuse sebaceous gland hyperplasia. A case report and an immunohistochemical study with cytokeratins.
We report a 43-year-old woman with sebaceous gland hyperplasia that occurred in a diffuse pattern of aggregated papular lesions involving her entire face, neck, and upper chest. Comedones, pustules, and inflammatory papules were absent. The eruption was accompanied by marked seborrhea. Histopathological examination showed enlargement of sebaceous acini, an increased number of immature sebocytes in foci, and a dilated follicular infundibulum. Immunohistochemical investigation showed cytokeratin 14 (CK 14) expression in the keratinocytes of the infundibulum, the isthmus, and sebaceous duct and in the mature and immature sebocytes; CK 17 expression in the keratinocytes of the sebaceous duct; CK 1 expression in the keratinocytes of the infundibulum; and an enhanced expression of the proliferation cell antigen Ki-67 (MiB1) in the immature sebocytes. With CK 18 and CK 19, no staining was observed. Oral therapy with isotretinoin (13-cis-retinoic acid) resulted in remarkable improvement in < or = 3 months. Histopathological and immunohistochemical examination after therapy showed markedly reduced sebaceous glands, a decrease in the staining of MiB1-positive immature sebocytes, and enhanced expression of CK 19 in immature sebocytes and sebaceous duct cells. Diffuse sebaceous gland hyperplasia is a rare variant of seboglandular proliferative disorders that is distinct from the well-known circumscribed type.
Administration, Oral↗
Measurement of plasma lactate concentration with Accusport.
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Animals↗
Reproducibility of the blood lactate-running speed curve in horses under field conditions.
OBJECTIVE: To examine the reproducibility of blood lactate-running speed curve parameters derived by a curve-fit equation and by linear interpolation from the results of 4-speed tests of sport horses under field conditions. DESIGN: Thoroughbreds completed 10 test pairs with 3 to 11 days between tests and retest. ANIMALS: 7 Thoroughbreds. PROCEDURE: The 4-speed test consisted of 4 runs over a distance of 2,110 m. Exercise intensity was increased by 1 m/s for each run. Blood lactate concentration measured after each run was plotted against running speed to determine the blood lactate-running speed relation. By means of the blood lactate-running speed relation, velocity inducing 2, 2.5, 3, 3.5, or 4 mM blood lactate concentration was calculated by a curve-fit equation and by linear interpolation. RESULTS: The test-retest correlation coefficient of velocity inducing 2, 2.5, 3, 3.5, and 4 mM blood lactate concentration determined by curve-fit equation was 0.67, 0.78, 0.84, 0.86, and 0.86, respectively, and by linear interpolation was 0.42, 0.58, 0.77, 0.87, and 0.78, respectively. But the test-retest regression was equal to the line of identity only for velocity inducing 3.5 and 4 mM blood lactate concentration. CONCLUSIONS: The reproducibility of velocity inducing 3.5 and 4 mM blood lactate concentration was sufficient to be used to compare horses and evaluate conditioning effects. This holds both methods of calculation of the parameters derived from the blood lactate-running speed relation.
Animals↗
Reduced echogenicity of brainstem raphe specific to unipolar depression: a transcranial color-coded real-time sonography study.
Echogenicity of the brainstem raphe was assessed in patients with major depression, bipolar affective disorders, and schizophrenia and compared with healthy adults employing transcranial color-coded real-time sonography. Forty probands were enrolled in each group. A highly significant reduction in raphe echogenicity was detected only in patients suffering from major depression. Echogenicity of the raphe was independent of age or sex and did not correlate with severity of the depressive syndrome or patient state. These findings are suggestive of structural desintegration of the brainstem raphe in unipolar depression, an anatomical region assumed to be a biological focus in the pathogenesis of depressive syndromes.
Adult↗
[Carcinoma of the prostate--the dilemma increases].
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Humans↗
[Hamartoma of the sebaceous follicle. An immunohistologic analysis with cytokeratins].
A 62-year-old man presented with a nodule 2 cm in diameter on his left cheek, which he had had since childhood. Histological examination showed a circumscribed dermal nodule composed of sebaceous lobules attached to sebaceous ducts and to an infundibular cyst-like structure connected to the epidermis. The wall was lined with squamous epithelium with a stratum granulosum. This structure was reminiscent of a sebaceous follicle. In addition, a melanocytic naevus of the compound type was found. Immunohistological investigations of the tumour with various cytokeratins revealed a pattern of expression characteristic for the mature sebaceous follicle.
Biomarkers, Tumor↗
[Draining sinus in acne and rosacea. A clinical, histopathologic and experimental study].
The draining sinus is an unpleasant complication of acne conglobata, acne fulminans, acne inversa, rosacea conglobata and rosacea fulminans (pyoderma faciale). It is most common on the face, especially in the nasolabial folds, and on the neck below the mandibular line. Clinically, it is an elongated (2-5 cm long), elevated, periodically inflamed lesion, which sporadically discharges pus. The lesion persists with no tendency to spontaneous regression. Histopathologically, it consists of elaborate, epithelialized galleries connected to the skin surface at multiple points. It contains corneocytes, hairs, bacteria, serum, inflammatory cells and epitheloid granulomas. A surgical thread placed into the skin provides a model in which the generation of sinus tracts can be studied. Therapy is difficult. Intralesional corticosteroid injection, cryosurgery and isotretinoin are not always very effective. Sometimes complete excision of the lesion is necessary. The draining sinus is a special form of scar analogous to the pilonidal cyst.
Abscess↗
Isolated meningeal tuberculoma mimicking meningioma: case report.
A 47-year-old German female patient is described with intracranial tuberculoma of the dura mater without history or evidence of tuberculosis and a negative tuberculin reaction. Computed tomography and magnetic resonance imaging and angiography resembled a meningioma. Diagnosis was verified by histology and identification of mycobacterium tuberculosis. After removal of the granuloma and high-dose chemotherapy, the patient was free of disease. Tuberculoma of the dura mater is an extremely rare disease in the Western European population.
Diagnosis, Differential↗