Clinical Neuroscience

[The importance of modern serological tests in the diagnosis and therapy of neurological disorders]

LAX Vera1, KLEIN Magda1

JULY 01, 1969

Clinical Neuroscience - 1969;22(07)

[Specific treponema assays were performed in the blood serum of 115 patients, both to provide serological evidence of clinically suspected neurolues without a history of luesian disease and to inform further treatment or management of patients with a known history of previously treated neurolues. Accordingly, the patient population was divided into 3 groups: group I for cases suspected of having neurolues, group II for cases with positive treponema reactions, group III for cases with known neurolues and negative treponema tests. In the assessment of the need for treatment, the positivity of treponema tests was found to be of minor importance compared to the possibilities offered by clinical observations, while the negativity of treponema tests was found to be a minor, not decisive factor in determining the cure. The diagnostic value of treponema tests in clinically probable neurological lesions, especially those manifesting as organic psychosyndromic symptoms, is of even greater importance. ]

AFFILIATIONS

  1. Budapest Főváros XIII. ker. Tanács V. B. Róbert Károly körúti kórháza Organikus Idegosztály

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Clinical Neuroscience

[Data on the pathogenesis of gliomas of the corpus callosum]

POÓR Gyula

[An anatomical-localisational analysis of 12 corpus callosum glioma cases, in addition to a review of the leading psychiatric and motor symptoms, was combined with a study of the findings of radiographic contrast studies. In addition to mentioning the value of the findings obtained by the two contrast methods, we emphasize that the two radiological aids can complement each other and that, therefore, in certain cases, we consider it necessary to perform both.]

Clinical Neuroscience

[Incidence of juvenile metachromatic leukodystrophy familiaris]

ABONYI Eszter, AMBRÓZY György, ANTAL János, BENKE Bálint, HÁMORI József

[Authors discuss the relatively rare juvenile-type matachromatic leukodystrophy (M.L.) familiaris. In our cases, the first symptom was forced feeding, followed by extrapyramidal symptoms and movement disorders. Total CSF protein was moderately elevated only in our more severe case. The peripheral nerve conduction was characteristically slowed. Chromosomal analysis of fvs cultures showed no abnormalities. Cultured chromosome analysis in both patients showed no abnormality. In both patients, biopsies were taken from the n. cut. surae-lat. and in one case from the frontal lobe of the brain. Histopathology revealed a moderate degree of neuropathy. The diagnosis of M. L. was confirmed in vivo on the basis of a characteristic histological picture showing brown metachromasia with acetic acid cresyl violet. Myelin sheath lesions in M. L. were examined by electron microscopy. Nodular stitching of small fragments of the myelin sheath and phagocytosis into the astrocyte were observed. The intra-sheath oligodendroglial protrusion was generally more massive than usual, presumably indicating increased regeneration. The observations provide data that inclusiform bodies may be derived from the myelin sheath. The authors discuss the difficulties of in vivo diagnosis of M. L. in the Discussion. They discuss the possible link between M. L. and epilepsy and the EEG, EMG and nerve conduction velocity abnormalities observed in their patients. Biochemical aspects of the aetiology of the disease are summarised. Based on the analysis of the siblings' family trees and literature data, it is considered possible that within a family there is a combination of different types of M. L. disorders.]

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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

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Clinical Neuroscience

[The role of sleep in the relational memory processes ]

CSÁBI Eszter, ZÁMBÓ Ágnes, PROKECZ Lídia

[A growing body of evidence suggests that sleep plays an essential role in the consolidation of different memory systems, but less is known about the beneficial effect of sleep on relational memory processes and the recognition of emotional facial expressions, however, it is a fundamental cognitive skill in human everyday life. Thus, the study aims to investigate the effect of timing of learning and the role of sleep in relational memory processes. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. Our results suggest that the timing of learning and sleep plays an important role in the stabilizing process of memory representation to resist against forgetting.]