Lege Artis Medicinae

[About the mortality rates of ischaemic heart disease]

MERKELY Béla, BECKER Dávid

NOVEMBER 20, 2011

Lege Artis Medicinae - 2011;21(11)

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Lege Artis Medicinae

[The Ear Problem of Francis II and the British Empire ]

GERLINGER Imre

Lege Artis Medicinae

[“Boys as victims”, or the potential public health consequences of childhood physical abuse]

GYŐRFFY Zsuzsa, IMOLA Sándor, CSOBOTH Csilla, KOPP Mária

[BACKGROUND - Whereas the scientific literature regarding physical abuse primarily focuses on female victims, few studies have been performed on the childhood abuse of men. The aim of our study was to examine the potential effects of childhood physical abuse of men on adult mental health status. METHODS - Data of 4675 male participants of the Hungarostudy nation-wide representative survey were analyzed. RESULTS - Altogether almost 13% of our study group reported physical abuse by a parent or other significant person. Compared with men who did not report abuse, depression, suicidal thoughts and attempts were significantly more common among abused men. Smoking, alcohol- and drugabuse, anxiety disorders and sleeping disorders also had a higher occurence. Moreover, we established that abused men had a significantly greater risk of marital distress and were more likely to have fewer children. Interpretation of the results in a multivariate model indicated that physical abuse is a determinate and independent risk factor of depression, suicidal thoughts and attempts, smoking habits and alcohol abuse. CONCLUSIONS - Our results underline that childhood physical abuse can have a significant effect on numerous mental disorders and maladaptive behaviours in adulthood. However, the deeper understanding of the relationship between physical abuse and mental disorders necessitates further studies.]

Lege Artis Medicinae

[The Languages of Apologizing]

SZONDY Máté

Lege Artis Medicinae

[Account on the Symposium of Coenzyme Q10 Association - Balatonfüred, 1st October 2011]

LIPTÁK Judit

Lege Artis Medicinae

[Are they really saved?]

VITRAI József, BAKACS Márta

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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.

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Clinical Neuroscience

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