Biomedical subjects
Publications and source records attributed to R Peschel.
Because neuroscience research has documented that mental illnesses are biologically-based brain diseases, our country should start training programs to create BBBD specialists. The National Alliance for the Mentally Ill has proposed a 2-track training system for psychiatric professionals--(1) A BBBD track and (2) a "mental health" track.
A physician may feel guilt and sorrow if he contributes, though innocently, to a patient's death. One radiation therapist, whose famous patient died, finds a parallel to his own experience in the case of the opera composer Giacomo Puccini, who died while being treated for cancer by his well-meaning radiotherapist.
The effects of a single dose of irradiation on the biomechanical parameters of the fracture healing process were studied in a rat model. Intramedullary pinning was performed before production of a closed femoral midshaft fracture. The experimental group was exposed to 900 rad 3 days after fracture and was compared with a control group with a similar fracture that received no irradiation. Animals were killed at intervals ranging from 2-16 weeks after surgery and the bones were tested until failure in torsion. In the irradiated groups, a delay of 4 weeks was noted in the biomechanical parameters associated with fracture healing (torque to failure, torsional stiffness, angle to failure, and biomechanical stage). Despite this delay in the normal temporal progression, the staging and stiffness approached normal controls within an 8-week period. However, the torque to failure remained below normal levels at the conclusion of this study. These results differ from a previous study using an open fracture model.
Because they wage a losing battle against death, all physicians resemble Sisyphus, eternally condemned to perform an impossible task. Yet like him, physicians must realize that the small successes they can achieve while contending against destiny are what count.
Forced to face the possibility of dying of cancer soon, a patient may question previous values and practices. A medical practitioner can learn a lot from such patients about fear, guilt, depression, and hope.
Malignant neoplasms known to develop following external beam radiation include squamous cell carcinoma, osteosarcoma, chondrosarcoma, malignant fibrous histiocytoma, mixed mullerian tumors, malignant schwannoma, myelogenous leukemia and angiosarcoma. Latency periods of many years characterize the onset of these tumors following the exposure. Cutaneous angiosarcoma following radiotherapy for breast carcinoma has been rarely documented, occurring up to 13 years postirradiation. Two cases of this entity are reported occurring 37 months postradiotherapy at the site of mastectomy performed for mammary duct carcinoma.
Among 67,930 autopsies 233 (0.3%) ruptured unoperated intracranial aneurysms were found. 105 aneurysms belonged to the anterior, 89 to the middle, and 29 to the posterior groups. The size, age and sex distribution of the aneurysms as well as the lesions due to their rupture were studied. The following complications were found (table 4): Massive subarachnoid haemorrhages (77%), intracerebral haematomas (61%), massive intraventricular haemorrhages (35%). Intracranial aneurysms were combined with polycystic degeneration of the kidneys in 8 patients. The pathomorphological findings were compared with the clinical diagnoses. The clinical diagnosis of a ruptured intracranial aneurysm was established in 13.9% of the patients only.
The composer Gaetano Donizetti, who died in a state of mental derangement due to neurosyphilis, created some of opera's greatest scenes of psychosis. His letters reveal the clinical progression of his neurobiological illness, which was confirmed by autopsy. One can hypothesize that the composer's brain disease, which led to his psychosis and death, may have had an influence on his ability to create the powerful and unforgettable scenes of psychosis in his operas. In Anna Bolena, he captured in musical and dramatic terms Anne Boleyn's historically corroborated mental disorder during her imprisonment in the Tower of London. Sixteen years after having composed Anna Bolena, Donizetti himself would be locked up, against his will, in a mental institution. In Lucia di Lammermoor, Donizetti portrayed a girl given to hallucinations who, in her unforgettable "mad" scene, comes on stage, a pathetic embodiment of a human being in the throes of psychosis. Thirteen years after Lucia's première, Donizetti would die, psychotic and paralyzed, of untreated neurosyphilis. Studying Donizetti's neurosyphilis and the portrayals of psychosis in his operas can help one to appreciate the pain of human beings trapped in the prison of a brain subjected to the devastation of mental derangement.