Clinical Neuroscience

[Data for the topochemistry of the Bielschowsky-type family of blind idiocy]

BALAJTHY Béla1

AUGUST 01, 1965

Clinical Neuroscience - 1965;18(08)

[In two brothers with late infantile typus amaurotic idiopathy, regional differences in the amount and composition of complex lipoid material stored in neurons were detected. For example : the lam. granularisa of the cerebellar cortex is almost intact, Purkinje elements represent the only cell type stored in its dendrites, the nucl. The thematic differences in the qualitative composition of the stored material are illustrated by a comparison of Purkinje and spinal cord motor neurons ; in the dendrites of Purkinje elements an alcohol-soluble glycolipid is stored, in the cell body the same material is found bound to protein and traces of sphingomyelin. In the motile cells of the spinal cord, the free glycolipid is minimal ; in these, mainly protein-bound glycolipid and sphingo myelin are stored. The regional behaviour of storage is identical in the two siblings, but there are important differences from most of the cases reported in the literature. These features suggest that, in addition to the common pathological moments that define the disease type, there are also variable topochemical endowments that appear to be familially determined. ]

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  1. Pécsi Orvostudományi Egyetem Ideg-és Elmeklinikája

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Clinical Neuroscience

[Diagnostic and aetiological problems in bridge lesions]

LEHOCZKY Tibor

[The importance and frequency of bridge lesions have been known since Kubik and Adams (1946).In my presentation I will focus on vascular and tumoral bridge lesions. I will only briefly refer to the other aetiological factors. Of my eight clinicopathological cases, 5 are anaemic or haemorrhagic infarcts, 3 are tumours; of these, 2 are intrapontine and 1 extrapontine. Of the 5 infarctus cases, symptoms developed acutely in 3 patients and subcutaneously in 2. ]

Clinical Neuroscience

[Bruxism and chronic headache]

VÁRADY Géza

[1. After describing the symptomatology and literature of bruxism (teeth grinding, empty grinding), the author investigated its relationship with chronic headache based on his own experience with patients. 2. "Bruxism cephalea" is a myogenic pain localized to the masticatory muscles, which aetiopathogenetically can be divided into psychogenic and orthodontogenic groups. 3. 19 out of 21 cases were dominated by psychogenitas, in which psychotherapeutic, sedative, general and local relaxation treatment resulted in the resolution of the typical complaints. In two cases orthodontic, stomatological sanatio resolved the irritative situation, secondary masticatory spasm. 4. In cases of chronic head and facial pain that defy any treatment, the possibility of bruxism, its pathogenetic role and the involvement of the stomatognathic system should be considered. ]

Clinical Neuroscience

[Hypnotic suggestibility and delusions of suggestibility in schizophrenic patients]

J. Nicsev

[1. suggestibility, the most typical hypnotic symptom, is also a feature of schizophrenia (as a chronic hypnotic state) 2. In hypnosis, the influence of real stimuli is established by psychological substitution 3. Substitution is characterized by a lower degree of unconsciousness of temporary relationships. It has associative, evocative, or visceral significance. 4. Substitution is the basis of suggestibility. 5. Hypotonicity of consciousness leads to regression of associations to the degree of substitution, the activity becomes automatic and creates a sense of being uninfluenced. 6. The patient's resistance to suggestion under conditions of increasing negativism becomes automatic resistance, and in negativism, it manifests itself in delusions of suggestion through personification ideas. 7. In schizophrenic patients, the suggestibility mechanism takes place at a lower level and is related to the pathophysiological essence of the disease, the chronic hypnotic state. ]

Clinical Neuroscience

[Reports]

MÁRIA Béla, TÖRÖK István

[1. Report on the XXVIII Italian Psychiatric Congress 2. Lindauer Psychotherapiewoche. 3-8 May 1965]

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Fluoxetine use is associated with improved survival of patients with COVID-19 pneumonia: A retrospective case-control study

NÉMETH Klára Zsófia, SZÛCS Anna , VITRAI József , JUHÁSZ Dóra , NÉMETH Pál János , HOLLÓ András

We aimed to investigate the association between fluoxetine use and the survival of hospitalised coronavirus disease (COVID-19) pneumonia patients. This retrospective case-control study used data extracted from the medical records of adult patients hospitalised with moderate or severe COVID-19 pneumonia at the Uzsoki Teaching Hospital of the Semmelweis University in Budapest, Hungary between 17 March and 22 April 2021. As a part of standard medical treatment, patients received anti-COVID-19 therapies as favipiravir, remdesivir, baricitinib or a combination of these drugs; and 110 of them received 20 mg fluoxetine capsules once daily as an adjuvant medication. Multivariable logistic regression was used to evaluate the association between fluoxetine use and mortality. For excluding a fluoxetine-selection bias potentially influencing our results, we compared baseline prognostic markers in the two groups treated versus not treated with fluoxetine. Out of the 269 participants, 205 (76.2%) survived and 64 (23.8%) died between days 2 and 28 after hospitalisation. Greater age (OR [95% CI] 1.08 [1.05–1.11], p<0.001), radiographic severity based on chest X-ray (OR [95% CI] 2.03 [1.27–3.25], p=0.003) and higher score of shortened National Early Warning Score (sNEWS) (OR [95% CI] 1.20 [1.01-1.43], p=0.04) were associated with higher mortality. Fluoxetine use was associated with an important (70%) decrease of mortality (OR [95% CI] 0.33 [0.16–0.68], p=0.002) compared to the non-fluoxetine group. Age, gender, LDH, CRP, and D-dimer levels, sNEWS, Chest X-ray score did not show statistical difference between the fluoxetine and non-fluoxetine groups supporting the reliability of our finding. Provisional to confirmation in randomised controlled studies, fluoxetine may be a potent treatment increasing the survival for COVID-19 pneumonia.

Clinical Neuroscience

Cases of inborn errors of metabolism diagnosed in children with autism

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Clinical Neuroscience

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

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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

Comparison of direct costs of percutaneous full-endoscopic interlaminar lumbar discectomy and microdiscectomy: Results from Turkey

ÜNSAL Ünlü Ülkün, ŞENTÜRK Salim

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Clinical Neuroscience

[The Comprehensive Aphasia Test in Hungarian]

ZAKARIÁS Lilla, RÓZSA Sándor, LUKÁCS Ágnes

[In this paper we present the Comprehensive Aphasia Test-Hungarian (CAT-H; Zakariás and Lukács, in preparation), an assessment tool newly adapted to Hungarian, currently under standardisation. The test is suitable for the assessment of an acquired language disorder, post-stroke aphasia. The aims of this paper are to present 1) the main characteristics of the test, its areas of application, and the process of the Hungarian adaptation and standardisation, 2) the first results from a sample of Hungarian people with aphasia and healthy controls. Ninety-nine people with aphasia, mostly with unilateral, left hemisphere stroke, and 19 neurologically intact control participants were administered the CAT-H. In addition, we developed a questionnaire assessing demographic and clinical information. The CAT-H consists of two parts, a Cognitive Screening Test and a Language Test. People with aphasia performed significantly worse than the control group in all language and almost all cognitive subtests of the CAT-H. Consistent with our expectations, the control group performed close to ceiling in all subtests, whereas people with aphasia exhibited great individual variability both in the language and the cognitive subtests. In addition, we found that age, time post-onset, and type of stroke were associated with cognitive and linguistic abilities measured by the CAT-H. Our results and our experiences clearly show that the CAT-H provides a comprehensive profile of a person’s impaired and intact language abilities and can be used to monitor language recovery as well as to screen for basic cognitive deficits in aphasia. We hope that the CAT-H will be a unique resource for rehabilitation professionals and aphasia researchers in aphasia assessment and diagnostics in Hungary. ]