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Clinical Neuroscience

JANUARY 30, 2021

Neuroscience highlights: The mirror inside our brain

KRABÓTH Zoltán, KÁLMÁN Bernadette

Over the second half of the 19th century, numerous theories arose concerning mechanisms involved in understanding of action, imitative learning, language development and theory of mind. These explorations gained new momentum with the discovery of the so called “mirror neurons”. Rizzolatti’s work inspired large groups of scientists seeking explanation in a new and hitherto unexplored area of how we perceive and understand the actions and intentions of others, how we learn through imitation to help our own survival, and what mechanisms have helped us to develop a unique human trait, language. Numerous studies have addressed these questions over the years, gathering information about mirror neurons themselves, their subtypes, the different brain areas involved in the mirror neuron system, their role in the above mentioned mechanisms, and the varying consequences of their dysfunction in human life. In this short review, we summarize the most important theories and discoveries that argue for the existence of the mirror neuron system, and its essential function in normal human life or some pathological conditions.

Lege Artis Medicinae

JANUARY 20, 2020

[American-Hungarian forerunners of humanistic psychology and medicine: Andras Angyal and Bela Mittelmann ]


[The fact that there are two significant Hungarian pioneers in humanistic psycho­therapy is still not recognised in the Hungarian academic community. In order to redress this omission the author compares and considers the careers of András Angyal and Béla Mittelmann. Both individuals left Hungary in 1920, settling first in Europe and subsequently in America, where they separately enjoyed successful careers. According to the author the trajectory of their lives is quite representative of many Hungarian emigrants during this period in history. This study examines the course of their life and explores their main achievements in the context of their contemporary relevance and enduring legacies. In the case of Angyal, it is the holistic-organismic theory of personality and influence on Maslow, which are his paramount achievements. As regards Mittelmann his topical contribution has been to the practice of “coaching” on the one hand and the application of dance and body therapy to recovery on the other. ]

Clinical Oncology

FEBRUARY 10, 2018

[The role of early clinical studies in oncology]


[Although the basic theory of the early development of different drug groups is identical, due to their various pharmacological characteristics the design of the studies, the starting safe dose and the selection of the pharmacologic and therapeutic end-points show signifi cant differences. The development process of drugs is usually divided into two functionally different parts, the learning and the confi rming phases, respectively. The aim of the fi rst part is the description of the suggested targets, the mechanism of action in humans and the characterization of the drug-linked biomarkers. This section contains the microdose (phase 0), phase I and II studies. The end-point of this part is the proof of the underlying concept which was developed on the basis of the non-clinical studies. According to the internationally accepted terminology, this strategically important point is called the Proof of Concept (POC). Upon POC it has to be decided whether the drug-candidate possesses those qualities which make it worthwhile to perform human phase III studies, treating the statistically required number of patients for proving the good therapeutic effi cacy and safety of the drug. This section of the drug development is called the confi rmatory phase. The use of highly sophisticated technology opened the possibility to apply microdoses in humans for studying the pharmacokinetics and pharmacodynamics of new drugs as well as the characteristics of human biomarkers at very low, harmless drug doses. This approach made possible to draw important conclusions on the usefulness of biomarkers for the clinical practice even following the fi rst drug-application. The planning of phases I and II studies, the calculation of the applicable doses, the selection of the pharmacologic and therapeutic end-points, the use of biomarkers, are all based on the concept of translational medicine and are essentially dependent on the results obtained both in animal experiments and human microdose studies.]

Lege Artis Medicinae

DECEMBER 21, 2020

[Family therapy encounters with the philosophy of dialogue – Ivan Boszormenyi-Nagy was born 100 years ago]


[This paper deals with the significant therapeutic innovations of Ivan Boszormenyi-Nagy in the light of their philosophical foundations. The greatest Hungarian family therapist, Boszormenyi-Nagy’s work evolved in America. The author, referring to Bo­szormenyi-Nagy’s career, presents the phi­losophical roots of his theory. Par­ti­cu­larly Martin Buber’s philosophy of dialogue including the concept of existential guilt, violanting the justice of human order. Bo­szormenyi-Nagy, who elaborated contextual therapy and its main dimension, the ethics of fairness, assumes that family life, ethical questions of truthworthiness and res­ponsibity for the consequences of our actions are inseparable. Contextual therapy was groundbreaking in its time with the therapeutic attitude and method of multidirected partiality, and is relevant even today. This guideline, requiring to include all people with their humanity, solidarity and accountability who are potentially affected remains sound clinical unifying principle of comprehensive psychotherapeutic practice. ]

Clinical Neuroscience

SEPTEMBER 30, 2020

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.

Lege Artis Medicinae

DECEMBER 10, 2018

[Identity formation of novel psychoactive substance users. Thematic content analysis of life narratives ]


[Authors rely on Susan Greenfield’s identity theory to explore life narratives of novel psychoactive substance users in a Hunga­rian sample (n=24). Main nodes of the conceptual network identified in the computer-aided content analysis were personal and institutional relational networks, processing of emotions and sensory experi-ence seeking.]

Lege Artis Medicinae

JUNE 20, 2018

[The “room” for death in the family - dying as a role]


[The Hungarian literature has quite ignored so far Noyes & Clancy’s Role Theory approach of dying. I present the outline and a critique of this conception, then lay the foundations of a reformed concept of the dying role. For the optimal and desired dying role is not one of peripherising and objectifying, rather one of placing the dying in the centre of the system of relations and roles radically restructuring under the influence of such role. The personality of the dying remains a true value in this central position. The reintegration of the dying can begin parallel to her disintegration by the progressive loss of her normal social roles (‘the loneliness of the dying’). Death can thus transform into a social phenomenon. I illustrate the argumentation on the central dying role with a case study using the method of a heterophenomenological, second-person character. By promoting the central and autonomous dying role, i.e. by the development of the necessary social role competences, or at least by publicising the thanatological knowledge, death can turn from an avoided, socially disintegrative taboo into a phenomenon that can strengthen the community even after the dying departed.]

Clinical Neuroscience

NOVEMBER 20, 2015

[Mentalizing deficit in neurological disorders: a review article]

HEROLD Róbert, VARGA Eszter, MIKE Andrea, TÉNYI Tamás, SIMON Mária, HAJNAL András, FEKETE Sándor, ILLÉS Zsolt

[Introduction – Mentalization is the ability to attribute mental states (intentions, desires, thoughts, emotions) to others, and hence to predict their behaviour. This ability fundamentally determines our participation in social relationships and adaptation to society. A significant proportion of the disorders of the central nervous system (CNS) affects those brain structures and neurotransmitter systems that play a role in the mentalizing processes. Accordingly, a number of CNS disorders may be associated with mentalizing deficits, which may affect the outcome of these diseases. Here, we review recent research on mentalizing abilities in neurological diseases. Methods – An internet database search was performed to identify publications on the subject. Results – Sixty-two publications in English corresponded to the search criteria. These publications reported impaired mentalization in several neurological disorders (e.g. epilepsy, Parkinson’s disease, multiple sclerosis, dementias, traumatic brain injury). Discussion – The results indicate that a number of neurological disorders associate with mentalizing deficit. This deficit is often present in the early stages of the diseases and has a prognostic value, which in turn emphasizes the importance of the early detection and adequate rehabilitation.]