Clinical Neuroscience

[Blood serum cholesterol in depression]

LÁNG Sándor1, HAITS Géza1

MAY 01, 1967

Clinical Neuroscience - 1967;20(05)

[1. In the vast majority of cases of various depressive states, fasting cholesterol levels are higher than normal. 2. In depressed patients, serum cholesterol levels are not elevated during the midday hours. 3. In depressed patients, serum cholesterol levels do not rise after cholesterol ingestion. ]

AFFILIATIONS

  1. Budapesti Orvostudományi Egyetem Psychiatriai Klinikája

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Clinical Neuroscience

[Statistical processing of 15 years of ES material from the Psychiatric Clinic of the Budapest Medical University]

ORVOSI Kara

[In the struggle for the cure of mental illnesses, for the health of the human mind, one of the central issues was therapeutic optimism, therapeutic activitas. The sick person and society as a whole expect the best possible restitution from the doctor, and the doctor's duty as a practitioner is to take responsibility, to take the lead, to apply the most modern methods of treatment. ]

Clinical Neuroscience

[Schizophrenia or schizophrenias]

DRIETOMSZKY Jenő, BRUNECKER Györgyi

[In analysing the development of the concept of "schizophrenia", both in terms of its professional history and its theoretical basis, authors adopt Nyirő's position that "...we cannot speak of schizophrenia, only of schizophrenics..." In the sense of Sternberg's concept, they narrow down their position by stating that a nosological approach and Leonhardian taxonomy are essential requirements for a substantive answer to the question.]

Clinical Neuroscience

[Resuscitation and neuropsychiatric therapy experiences with electrostimulator]

FORNÁDI Ferenc, BARTOS Valéria, ZSOMBÓK György, KAFFKA Károly

[The authors describe their joint research with Nyirő on the therapeutic value of transcerebral electrostimulation. Their experience: 1. electrostimulation is essential not only in the treatment of respiratory paralysis following electrotrauma, but also in the prevention and treatment of certain complications of psychiatric so-called major somatic treatments; 2. it is also a new treatment option for hormone-refractory hypothalamic syndromes, such as amenorrhoea, using more mitigated current parameters. ]

Clinical Neuroscience

[The problems of the psychoanalytical distinguishing between typical and atypical types of drunkenness]

HUSZÁR Ilona, IRÁNYI Jenőné

[In their communication, the authors deal with the differentiation of acute, typhoidal intoxication states from atypical (pathological) intoxication states, emphasising the sociological importance of the differentiation and defining the legal basis for the differentiation. The work of Nyirő on the subject is discussed in detail, followed by a discussion of the symptoms of atypical intoxication and their diagnostic significance. They also analyse all the external and internal factors that may play a role in the development of atypical drunkenness. It is considered possible to distinguish between the two forms of intoxication only by examining all the factors in each case in context, but it is stressed that a sharp dividing line cannot always be drawn. ]

Clinical Neuroscience

[The role of exogenous factors in psychiatric disorders ]

IVÁN László, TAKÁCS László, PETHŐ Bertalan

[Authors discuss the psychopathological significance of isolation or deprivation. They draw attention to these specific exogenous factors and stress the importance of a multidimensional approach in their interpretation. Using both the literature and their own clinical experience, they aim to outline certain conclusions on this topic. ]

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Late simultaneous carcinomatous meningitis, temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting with mono-symptomatic vertigo – a clinico-pathological case reporT

JARABIN András János, KLIVÉNYI Péter, TISZLAVICZ László, MOLNÁR Anna Fiona, GION Katalin, FÖLDESI Imre, KISS Geza Jozsef, ROVÓ László, BELLA Zsolt

Although vertigo is one of the most common complaints, intracranial malignant tumors rarely cause sudden asymmetry between the tone of the vestibular peripheries masquerading as a peripheral-like disorder. Here we report a case of simultaneous temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting as acute unilateral vestibular syndrome, due to the reawakening of a primary gastric signet ring cell carcinoma. Purpose – Our objective was to identify those pathophysiological steps that may explain the complex process of tumor reawakening, dissemination. The possible causes of vestibular asymmetry were also traced. A 56-year-old male patient’s interdisciplinary medical data had been retrospectively analyzed. Original clinical and pathological results have been collected and thoroughly reevaluated, then new histological staining and immunohistochemistry methods have been added to the diagnostic pool. During the autopsy the cerebrum and cerebellum was edematous. The apex of the left petrous bone was infiltrated and destructed by a tumor mass of 2x2 cm in size. Histological reexamination of the original gastric resection specimen slides revealed focal submucosal tumorous infiltration with a vascular invasion. By immunohistochemistry mainly single infiltrating tumor cells were observed with Cytokeratin 7 and Vimentin positivity and partial loss of E-cadherin staining. The subsequent histological examination of necropsy tissue specimens confirmed the disseminated, multi-organ microscopic tumorous invasion. Discussion – It has been recently reported that the expression of Vimentin and the loss of E-cadherin is significantly associated with advanced stage, lymph node metastasis, vascular and neural invasion and undifferentiated type with p<0.05 significance. As our patient was middle aged and had no immune-deficiency, the promoting factor of the reawakening of the primary GC malignant disease after a 9-year-long period of dormancy remained undiscovered. The organ-specific tropism explained by the “seed and soil” theory was unexpected, due to rare occurrence of gastric cancer to metastasize in the meninges given that only a minority of these cells would be capable of crossing the blood brain barrier. Patients with past malignancies and new onset of neurological symptoms should alert the physician to central nervous system involvement, and the appropriate, targeted diagnostic and therapeutic work-up should be established immediately. Targeted staining with specific antibodies is recommended. Recent studies on cell lines indicate that metformin strongly inhibits epithelial-mesenchymal transition of gastric cancer cells. Therefore, further studies need to be performed on cases positive for epithelial-mesenchymal transition.

Clinical Neuroscience

Alexithymia is associated with cognitive impairment in patients with Parkinson’s disease

SENGUL Yildizhan, KOCAK Müge, CORAKCI Zeynep, SENGUL Serdar Hakan, USTUN Ismet

Cognitive dysfunction (CD) is a common non-motor symptom of Parkinson’s disease (PD). Alexithy­mia is a still poorly understood neuropsychiatric feature of PD. Cognitive impairment (especially visuospatial dysfunction and executive dysfunction) and alexithymia share com­mon pathology of neuroanatomical structures. We hypo­thesized that there must be a correlation between CD and alexithymia levels considering this relationship of neuroanatomy. Objective – The aim of this study was to evaluate the association between alexithymia and neurocognitive function in patients with PD. Thirty-five patients with PD were included in this study. The Toronto Alexithymia Scale–20 (TAS-20), Geriatric Depression Inventory (GDI) and a detailed neuropsychological evaluation were performed. Higher TAS-20 scores were negatively correlated with Wechsler Adult Intelligence Scale (WAIS) similarities test score (r =-0.71, p value 0.02), clock drawing test (CDT) scores (r=-0.72, p=0.02) and verbal fluency (VF) (r=-0.77, p<0.01). Difficulty identifying feelings subscale score was negatively correlated with CDT scores (r=-0.74, p=0.02), VF scores (r=-0.66, p=0.04), visual memory immediate recall (r=-0.74, p=0.01). VF scores were also correlated with difficulty describing feelings (DDF) scores (r=-0.66, p=0.04). There was a reverse relationship bet­ween WAIS similarities and DDF scores (r=-0.70, p=0.02), and externally oriented-thinking (r=-0.77,p<0.01). Executive function Z score was correlated with the mean TAS-20 score (r=-62, p=0.03) and DDF subscale score (r=-0.70, p=0.01) Alexithymia was found to be associated with poorer performance on visuospatial and executive function test results. We also found that alexithymia was significantly correlated with depressive symptoms. Presence of alexithymia should therefore warn the clinicians for co-existing CD.

Lege Artis Medicinae

[The author’s response to the comment on “Exploratory study of outcomes of blood sample mass examinations by rank correlations”]

Lege Artis Medicinae

[Diagnosis and treatment of microvascular coronary heart disease. Specialities of conditions in Hungary]

SZAUDER Ipoly

[Invasive investigations show that in two-thirds of patients the myocardial ischaemia persists without obstructive coronary disease and any other heart conditions (INOCA). The underlying cause may be microvascular dysfunction (CMD) with consecutive microvascular coronary disease (MVD) and microvascular or epicardial vasospastic angina (MVA). The modern practice of clinical cardiology while using the developed non-invasive cardiac imaging permits exact measuring of the coronary flow with its characteristic indices. All of these improve the diagnosing of CMD-induced myocardial ischemia and provide opportunity to determine primary MVD cases. Since the recognition and treatment of MVD is significantly underrep­resented in the Hungarian medical care, the primary stable microvascular angina (MVA) is described in detail below with its modern invasive and non-invasive differential diagnosis and treatment, concerning especially its frequency provoked by high blood pressure and female coronary heart diseases. There are highlighted all recommended diagnostic procedures available under domestic conditions.]

Lege Artis Medicinae

[History of vaccine production in Hungary ]

ÓCSAI Lajos

[This study presents the complete history of the Hungarian vaccine production, partly in association with the process of fighting vaccine-preventable infectious diseases, and underlines the fact that every government actively contributed to the age-adjusted mandatory vaccination schedule of the past 140 years. It demonstrates the various achievements from the smallpox lymph production through the launch of diphtheria serum production at Phylaxia and the establishment of the National Public Health Institute (OKI) with its vaccine production and the later institutional transformation of OKI into Humán as economic corporation to its closure. Among all OKI’s vaccine production activities, this study focuses on the production of influenza vaccines, due to its international importance in the 1960s and 1970s. The vaccine production against diphtheria tetanus and pertussis stands out from Humán’s activities, and the tetanus component of this vaccine is still used in the products of a multinational vaccine manufacturer. ]