[A rapid demonstration of phagocytic cells from amniotic fluid in cases of neural tube defects].
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Biomedical subjects
Publications and source records attributed to Z Papp.
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141 female psychiatric patients, suffering from major depression, schizophrenia, alcohol dependence or adjustment disorder, were investigated for their 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid (HVA) and cortisol level in the cerebrospinal fluid (CSF). Dexamethasone suppression tests were also performed in 111 cases, and TRH/TSH tests in 40 subjects. Fifty-two patients were hospitalized following a recent suicide attempt, 18 of which were made using a violent method. The other 34 attempters took tranquilizer or sedative overdoses. CSF 5-HIAA was significantly lower in violent attempters in all 4 diagnostic categories. CSF HVA was higher in those taking drug overdoses, but only in depression (and less markedly in schizophrenia). CSF cortisol did not differ among either diagnostic or suicidal subgroups. Dexamethasone suppression was more frequently abnormal in suicidal patients than in nonattempters, and this difference was more important where the overall nonsuppression rate was lower. Maximal TSH response to TRH showed an inverse correlation with CSF 5-HIAA, and it was lowest in the nonattempter group. The difference between violent suicide attempters and nonattempters in their TSH response was significant. Since these biochemical changes were more or less independent of clinical diagnoses, it seems relevant to explore further the biological background of human aggression and suicide as a separate research direction.
Fifteen healthy women and 64 female psychiatric inpatients (major depression: 17, schizophrenia: 24, alcohol dependence: 9, and adjustment disorder: 14 cases) without identifiable thyroid dysfunction were investigated with the TRH test under comparable circumstances. Although all patient groups showed some tendency toward lower baseline TSH and smaller TRH-induced TSH responses, only patients with major depression demonstrated marked, statistically significant differences from controls in both variables. Women with alcohol dependence (in the early withdrawal period) showed significantly decreased TSH responses to TRH but only a weak tendency to lower basal TSH levels. Intergroup differences in the TSH response remained significant after correction for basal TSH by analysis of covariance. Neither variables correlated significantly with age, weight or body height, but baseline TSH correlated with body surface. The TRH test, using only 0.2 mg TRH for stimulation, seemed to be useful for identifying major depression and showed that early withdrawal from alcohol may be a factor to be considered in similar studies.
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A case of prenatally diagnosed hygroma colli is presented. Prenatal diagnosis, characteristic ultrasonic signs as well as problems of differential diagnosis are discussed. The importance of non-elective routine ultrasound screening in the early detection of fetal congenital malformations is emphasized.
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The effect of 1 mg dexamethasone on CSF levels of 5-hydroxyindoleacetic acid (5 HIAA), homovanillic acid (HVA) and cortisol (CS) was investigated in 100 psychiatric inpatients: 45 subjects had their lumbar punctures 1-4 days following dexamethasone administration, and the results were compared with those from 55 other patients investigated before drug ingestion. All patients were women, and none had received psychotropic medication for at least two weeks before the study. Seven subjects consented to two LPs both before and after dexamethasone. As expected, cortisol in the CSF significantly decreased after dexamethasone: the decrease was greatest 10 hours following the drug. HVA showed a weak and transient elevation after 10 hours only. CSF 5 HIAA was found to be significantly increased in postdexamethasone samples and high levels were still found even after 82 hours. Diagnostic differences (major or minor depression, schizophrenia, alcohol abuse or dependence) did not account for the observed differences. Repeated CSF examinations in seven subjects corroborated these findings: all cortisol values were decreased and all 5 HIAA values were increased after dexamethasone while HVA values showed random changes. The data may suggest that serotonergic mechanisms may be involved in dexamethasone action in the CNS. In addition, dexamethasone administration can alter CSF 5 HIAA level, a possible factor which should be taken into consideration in CSF studies.
5-Hydroxyindoleacetic acid (5HIAA), homovanillic acid (HVA), cortisol (CS), tryptophan (TRY), and calcium (Ca) concentrations were measured in the spinal fluid of 85 female psychiatric inpatients in a drug-free state; 32 women suffered from major depression, another 32 had schizophrenic (or schizophreniform) disorder, and 21 had alcohol dependence as defined by DSM-III criteria. A dexamethasone suppression test (DST) was carried out following lumbar punctures in all patients. Biochemical results were analyzed by two-way analysis of variance to test the effect of diagnosis and dexamethasone nonsuppression. CS concentration proved to be significantly higher in dexamethasone nonsuppressors, independent of the diagnosis. HVA was lower in nonsuppressors, particularly in alcohol-dependent patients; 5HIAA showed a tendency to be higher in nonsuppressor depressed patients. TRY was again higher in nonsuppressors, significant only in schizophrenic patients. Ca concentration was higher in depression and lower in alcohol dependence, and within the depression group it was higher in normal DST patients. The results indicate that the primarily biological dysfunction, i.e., the limbic-hypothalamic disinhibition reflected in the DST, may be more closely related to spinal fluid biochemistry than clinical syndromes.
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A case of antenatally diagnosed thanatophoric dysplasia is described. Other syndromes accompanied by chondrodysplastic tetramicromelia were excluded and diagnosis was based on the narrow thorax, secondary pulmonary hypoplasia and macrocephaly detected by ultrasound and on radiological findings of disturbed bone formation. At the mother's request labour was induced and radiological, anatomic and histological examination of the newborn confirmed the prenatal diagnosis. On basis of the literature, the possible aetiology of the disease is discussed and autosomal recessive heredity is suggested. Attention is focussed on the significant hydramnios which led to the suspicion of fetal malformation. The importance in pregnancy of routine ultrasound screening is emphasized, since such malformations can be detected as early as in midtrimester pregnancy.