Clinical Neuroscience

[Experimental eosinophil number changes in response to a new iminodibenzyl derivative]

ANTAL János1

OCTOBER 01, 1960

Clinical Neuroscience - 1960;13(10)

[We investigated the effect of a new iminodibenzyl derivative, Tofranil, on the eosinophil count in circulating blood and the eosinopenia reactivity. We found that at a dose of 0.1-0.5 mg/100 g, the eosinophil cell count almost doubled after a weekly daily dose. At higher doses (1-5 mg/100 g), a single injection can maintain high eosinophil levels after one week. Also at a high dose (1-5 mg/100 g), eosinophilia develops as early as 4 hours after injection. Thyroidectomy abolishes the eosinophilic effect of Tofranil acut. High dose given once daily (1--5 mg/100 g) or low dose given daily for a week (0.1-0.5 mg/100 g) prevents eosinophilic reaction to 50 pg epinephrine administration 4 hours after onset. Inhibition of eosinopenia was only minor when administered as a single small dose or when Tofranil was given one hour before epinephrine. It is assumed that Tofranil induces complex neuroendocrinological effects in rats.]

AFFILIATIONS

  1. Budapesti Orvostudoményi Egyetem Neurológiai Klinika

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Clinical Neuroscience

[Data on female alcoholism]

BÖSZÖRMÉNYI Zoltán, SRÁGLI Gyula

[The Communication looks at the increasing prevalence of alcoholism among women worldwide, according to statistical data ; it presents the main data available to explain this phenomenon. The authors have derived their own findings from a comparative study of the histories of 303 female patients discharged from the National Institute of Neurology and Mental Health between 1 January 1954 and 31 December 1959, and of 150 male alcoholics from the same period, used as a control. They found a smaller increase in the number of female alcoholics, and that the majority of women are withdrawn much earlier than men, with a higher incidence of alcoholism in their families. The majority of women drinkers are only engaged in domestic or other simple-primitive work. Only 15.3% of women and 42% of men were considered to be normal drinkers, with the latter making much less effort to explain their drinking. Women are more withdrawn in group psychotherapy sessions, but seem to need this treatment more than men. The authors present three illustrative case reports. They conclude that the rise in the number of women alcoholics should not be accepted as a necessary consequence of the neutralisation process (Bürger-Prinz), but should be combated by adequate education.]

Clinical Neuroscience

[Intracranial metastasis]

GOMBI Róza, HULLAY József

[The authors report clinical, surgical and pathological evaluation of 35 operated brain metastases. In their material, metastasis represented 9% of brain tumour cases. Postoperative mortality was 17%. Postoperatively, the mean survival of patients was 8 months and the overall survival was 51%. Based on the surgical and pathological picture, a percutaneous tumor cell embolus metastasis mechanism is considered likely and suggests that cortico-subcortical cancer metastases removed by radical resection do not recur locally. Most of these cases were cancer metastases. In their dissected cases, multiple brain metastases were always found. In terms of localisation, frontal metastases (42%) and primary tumours located in the lung (42%) were the most common. Regarding the question of surgical indications, it is pointed out that the principle that only solitary metastases should be operated on is not feasible in practice, due to current diagnostic capabilities and for reasons that, apart from absolute infaust cases, argue in favour of surgery in cases of multiple metastases. ]

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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

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Myasthenia gravis (MG) is an autoimmune disorder of neuromuscular transmission. Autonomic dysfunction is not a commonly known association with MG. We conducted this study to evaluate autonomic functions in MG & subgroups and to investigate the effects of acetylcholinesterase inhibitors. This study comprised 30 autoimmune MG patients and 30 healthy volunteers. Autonomic tests including sympathetic skin response (SSR) and R-R interval variation analysis (RRIV) was carried out. The tests were performed two times for patients who were under acetylcholinesterase inhibitors during the current assessment. The RRIV rise during hyperventilation was better (p=0.006) and Valsalva ratio (p=0.039) was lower in control group. The SSR amplitudes were lower thereafter drug intake (p=0.030). As much as time went by after drug administration prolonged SSR latencies were obtained (p=0.043).Valsalva ratio was lower in the AchR antibody negative group (p=0.033). The findings showed that both ocular/generalized MG patients have a subclinical parasympathetic abnormality prominent in the AchR antibody negative group and pyridostigmine has a peripheral sympathetic cholinergic noncumulative effect.

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

[A short chronicle of three decades ]

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[Hungarian professional periodicals started quite late in European context. Their publish­ing, editing and editorial philosophy were equally influenced by specific historical and political situations. Certain breaking points of history resulted in termina­tion of professional journals (War of In­de­pendence 1848-1849, First and Se­cond World Wars), however there were pe­riods, which instigated the progress of sciences and founding of new scientific journals. Both trends were apparent in years after the fall of former Hungarian regime in 1990. The structure of book and journal publishing has changed substantially, some publishers fell “victim” others started successfully as well. The latters include the then-established publishing house Literatura Medica and its own scientific journal, Lege Artis Me­di­cinae (according to its subtitle: New Hun­garian Medical Herald) issued first in 1990. Its appearance enhanced significantly the medical press market. Its scientific publications compete with articles of the well-established domestic medical journals however its philosophy set brand-new trends on the market. Concerning the medical community, it takes on its problems and provides a forum for them. These problems are emerging questions in health care, economy and prevention, in close interrelation with system of public health institutions, infrastructure and situation of those providing individual health services. In all of them, Lege Artis Medicinae follows consequently the ideas of traditional social medicine.]

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[Risk of nonsteroidal antiinflammatory drugs. Focus on aceclofenac]

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[Nonsteroidal antiinflammatory drugs (NSAIDs) are among the most frequently used pharmaceuticals. Nevertheless, a number of studies emphasized that NSAIDs were damaging not only the gastrointestinal (GI), but also the cardiovascular (CV) system, could increase the blood pressure, the frequency of coronary events (angina, myocardial infarction) and stroke incidence, as well as they might deterio­rate renal functions. The National Institute for Health and Care Excellence (NICE) did not find evidence that administering NSAIDs could increase the risk of developing COVID-19 or worsened the condition of COVID-19 patients. However, unwanted effects of specific drugs differ substantially in their occurrence and seriousness as well. It seemed to be for a long time that the NSAIDs provoked higher GI-risk was closely related to the COX1/COX2 selectivity, like the cardiovascular (CV) risk to the COX2/COX1 selectivity, however, the recent data did not prove it clearly. Based on the available literature while pondering the gastrointestinal and cardiovascular adverse events, among all NSAIDs the aceclofenac profile seemed to be the most favourable.]