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PubMed1980

The clinical value of the palmomental reflex.

The age specific incidence of the palmomental reflex (PMR) has been investigated in persons without any former or present evidence of a neurological or mental involvement. Also excluded were persons with hypertension, diabetes mellitus, thyroid dysfunction, alcohol abuse and other diseases as these could effect the central or peripheral nervous system. From the newborn period up to the age of 20 years the incidence of the PMR was between 3,3% and 20%, the differences being statistically insignificant. After the age of 20 years the incidence of the PMR rises with increasing age, the rise being approximately 10% per decade. There was no asymmetry of the PMR in persons without affection of the nervous system and who met the above mentioned criteria. Since a symmetrical PMR can be found in a considerable percentage of persons with no indication of a neurological or mental involvement, it should not be considered as a pathological sign. An asymmetrical PMR was found in 20 persons who did not meet the above mentioned criteria. In 5 out of these 20 persons additional neurological signs could be detected. 9 patients had histories of brain trauma, meningitis, cerebrovascular disease and polyneuropathy. 9 others were suffering from severe cardiovascular disease, carcinoma and alcohol abuse. In only one patient, although presenting with some neurological signs, no relevant history could be detected. An asymmetrical PMR, therefore, must be considered as a discrete indication of an involvement, either of the central or the peripheral nervous system. The PMR has no certain localizing significance.

Adolescent↗
PubMed1999

[Melancholia and neurotic depression].

The author considers the psychopathological distinction between endogenous and neurotic depression as one of differing psychodynamics. In so doing he embeds both illnesses within psychoanalytic theory while at the same time allowing a sharp differentiation. Even the premorbid personalities of patients with endogenous and neurotic depression are different. The personalities of those with endogenous depression bear a similarity to those with obsessional character and betray a pathological super-ego monopolized by defence mechanisms. The personalities of patients with neurotic depression show an oral-dependent structure characterised by a structural deficit of the ego functions and of an autonomous super-ego. These factors are responsible for the greatly differing pathodynamics found in these illnesses and point to different etiological factors in socialization.

Depressive Disorder↗
PubMed1987

[Role of current large-film fluorography in the improved diagnosis of gastric polyps in mass screening of the population].

The paper is concerned with a study of present-day potentialities for improving the diagnosis of stomach polyps. As the main diagnostic method the authors proposed gastric LFF with subsequent (as per indications) endoscopic examination of persons at high risk of development of the above pathology. Proceeding from an analysis of 110 cases of stomach polyps diagnosed at examination of over 11000 persons at high risk of developing stomach tumors, the authors emphasized a high efficacy of the proposed methods to find a solution to the problem of improving polyp diagnosis and issued their recommendations for their introduction into practice.

Adult↗
PubMed1983

[The psychology of chronic rheumatism patients based on the Rorschach test].

The objective of this research was to try to see if it was possible to find in a population of chronic rheumatickies (a great majority of P.C.E.) some specific psychologie characteristics or constants among these sicks. So we have used Rorschach test. On the based of 19 persons inspected, we have found 84% who present a pathological inhibition and 68% a pathological anxiety. They are datums more strikingness, but we have found others interesting indications. For example: 47% persons presented symptoms of a affectivity no stabilize egocentric and impulsive and had a perturbed thought by their affectives problems. 21% a deficient valuation of reality. We have terminated trying to discuss two others questions from datums collected.

Adult↗
PubMed1990

Long-term recovery patterns of severe dysarthria following head injury.

This study gives detailed information regarding the changes of bulbar dysfunction in a long-term follow-up of four severely brain-damaged young persons. There are similarities in the pathology and symptomatology of the four and all made measurable improvements albeit these did not start for some considerable time following injury. Few gains in bulbar function were noted in the first 18 months. One subject began to improve after 24 months, another after 30 months with the most substantial changes for all subjects being seen by 48 months post-injury. Further small improvements continued to be recorded up until the end of the study. The four subjects with severe dysarthria and profound physical disability following head injury were monitored for 7 years. All were assessed using the Frenchay Dysarthria Assessment (FDA) at regular intervals. The gains were not so significant that any became independent oral speakers. Although the subjects remain severely dysarthric and all use communication aids, the improvements are seen to have functional relevance. The timing of the maximum improvement was noted to follow the cessation of specific remediation of bulbar function. The results of this study raise interesting questions with regard to neurological recovery and rehabilitation management. It is possible to speculate that oral/motor therapy should be implemented at a later stage with severely head-injured patients in an attempt to exploit and extend returning function.

Adolescent↗
PubMed2001

[Breast cancer and its psychological approach: family, others, chance and...me].

Since several years already, the scientific literature evoked the psycho-oncological perspective in the psychotherapeutic treatment of the patient suffering of a malignant mammary pathology. The objective of this article is to insist on some characteristics of personality inherent to the individual that suffers of a malignant mammary pathology. Comparing three groups of women (malignant mammary pathology--n = 51, benign mammary pathology--n = 71 and a group controls--n = 30), a set of questionnaires relating to locus of control and to the close circle--family and couple--has been managed. Results indicate that the woman suffering of a breast cancer is less "intern", consider that her health depends on factor "luck" and wish less cohesion and therefore more of distance within her couple and her family.

Adult↗
PubMed2001

Serologic markers of Epstein-Barr virus infection and nasopharyngeal carcinoma in Taiwanese men.

BACKGROUND: It is probable but unproven that Epstein-Barr virus (EBV) has a role in nasopharyngeal carcinoma. We determined whether antibodies against EBV are present before the development of nasopharyngeal carcinoma. METHODS: A total of 9699 men were enrolled between 1984 and 1986. Blood samples were examined for IgA antibodies against EBV capsid antigen and neutralizing antibodies against EBV-specific DNase. During 131,981 person-years of follow-up, 22 pathologically confirmed new cases of nasopharyngeal carcinoma that were diagnosed more than one year after recruitment were ascertained through linkage with the National Cancer Registry of Taiwan. RESULTS: The cumulative risk of nasopharyngeal carcinoma per 100,000 person-years was 11.2 for subjects who tested positive for neither serologic marker, 45.0 for those who had one marker, and 371.0 for those who had both markers. After adjustment for age and the presence or absence of a family history of nasopharyngeal carcinoma, the relative risk of nasopharyngeal carcinoma was 32.8 for subjects with both markers (95 percent confidence interval, 7.3 to 147.2; P<0.001) and 4.0 for subjects with one marker (95 percent confidence interval, 1.6 to 10.2; P=0.003), as compared with subjects with neither marker. The longer the duration of follow-up, the greater the difference in the cumulative incidence of nasopharyngeal carcinoma between seropositive and seronegative subjects. CONCLUSIONS: IgA antibodies against EBV capsid antigen and neutralizing antibodies against EBV DNase are predictive of nasopharyngeal carcinoma.

Antibodies↗
PubMed1999

[Rudolf Virchow 1821-1902. Physician, politician, historian and anthropologist].

Rudolf Virchow was born in Pomerania in 1821 in Prussia/Germany. His father was a cashier. He started his medical studies in 1839 and finished them in 1843. He became one of the most famous physicians of the 19th century, as he founded the "Cellular pathology" theory. This claims that disease and pathological change start in the cell and nowhere else. The ruling medical dogma at that time the "humoral pathology" stated that "body fluids" were in inbalance when a person got sick. Virchow's studies cleaned this out and the hallmark of the "cellular pathology" sounded "omnis cellula e cellula" ("behind every cell there is another cell"). Virchow was a Professor of Anathomy, Pathology and Physiology and was about the first medical doctor to introduce leukemia, embolus, trombosis and cancerous lymphoid glands into our vocabulary. He worked most of his time in Berlin. He was also a famous and powerful politician throughout his entire life, fighting for political rights, universal suffrage, economic reforms and loosening of the grip of the church. He was also struggling for peace and international understanding. Moreover he was engaged in Anthropology and active as an Archeologist-Historian. He was married and had 6 children. Rudolf Virchow is one of the most famous scientist of the nineteenth-century, referred to as a person of most authority by, among others, Darwin and Nietsche. He was the writer of numerous medical books, the founder of medical journals and the leader of several scientifical organizations. He died in 1902 in Berlin in the aftermath of a tramway-accident when he was on his way to an archeological scientific meeting, at 81 years of age.

Anthropology↗
PubMed1998

A new perspective on gender orientation measurement with the MMPI-2: development of the Masculine-Feminine Pathology Scale.

A new scale of gender orientation for the MMPI-2 (Minnesota Multiphasic Personality Inventory-II; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) called the Masculine-Feminine Pathology Scale, or Mfp, was developed as an alternative to the available Mf, GM, and GF scales. It differs from previous scales in its emphasis on symptomatic correlates of gender. Items were included in the new scale if they (a) discriminated between male and female psychiatric patients and (b) were likely to be indicators of psychopathology. Statistical analyses suggested an acceptably reliable but factorially complex scale. When used to predict clinician ratings of global psychopathology, the scale demonstrated incremental validity over both the existing gender-related scales and the traditional clinical scales. Scores at the "feminine" end of the Mfp scale seem to reflect distress characterized by high levels of anxiety. Scores at the "masculine" end of the Mfp scale suggest a more composed interpersonal presentation, which may reflect an amoral attitude. It is suggested that the new scale may prove superior to the existing gender role scales as a supplement to other clinical scales. Avenues for future research with the Mfp scale are discussed.

Adult↗
PubMed1988

[Indicator of periodontal therapeutic needs (CPITN) in adults aged between 35-44 years from three population groups in Cracow province].

Parodontological therapeutic needs in 180 persons aged between 35-44 years among inhabitants of Cracow, Wieliczka and villages of Cracow province have been determined. Among women and men under examination the following needs have predominated: the necessity of dental deposits removal and curretage of pathological gingival pockets (75.56--77.78%). In 39 persons (21.68%) there was a need of complex treatment.

Adult↗
PubMed1996

Obsessive-compulsive disorder comorbid with borderline personality disorder: a long-term case study.

Three case reports of patients with borderline personality disorder (BPD) and obsessive-compulsive disorder (OCD) for more than 10 years are used to illustrate the relationship between OCD and borderline pathology. The recognizable features of the obsessive-compulsive symptoms in these reports are: (i) pervasiveness, the symptomatic overlap of obsessive-compulsive symptoms; (ii) poor insight and resistance; and (iii) obsessive control evident in personal relationships. These features are manifestations of OCD psychopathology as well as of a personality disorder. The symptoms with these features are located hypothetically towards the severe end of the symptomatic spectrum of OCD. The comorbidity is not a simple relationship, and the symptomatology of the comorbid patient is derived from OCD pathology linked with the personality disorder rather than from independent BPD pathology.

Adolescent↗
PubMed1989

Role models in pathology. A new look at an old issue.

Recent trends indicate that pathology is becoming a less attractive specialty to US medical graduates. This article discusses role models as an important but underutilized tool in medical education, and pathology education, in particular. Historically, the term role model has been used to describe a hero or a good teacher. Social scientists who study specialty choices in medicine, however, consider role model to be a much more heterogeneous concept. The information gained from these studies, therefore, needs to be sorted out carefully if erroneous conclusions about role models are to be avoided. For example, personality traits and attitudinal assessment studies encourage, unfortunately, either a totally passive stance toward recruitment, or a selective approach to those students who fit the specialty profile. However, there is no available evidence to support such approaches in pathology. Indeed, faculty role models have consistently been found to be influential recruiters into specialties that are not well known to the students (eg, pathology). Many different types of role models are present in pathology. Two important types are clinical consultants and physician-researchers. Positive faculty role models are an effective way to remove false impressions and negative assumptions about the practice of pathology, and they should be used more explicitly in recruiting efforts.

Attitude of Health Personnel↗
PubMed1995

Carbon disulphide. II. Investigations on the uptake of CS2 and the excretion of its metabolite 2-thiothiazolidine-4-carboxylic acid after occupational exposure.

The reported investigations on the uptake of carbon disulphide (CS2) and the excretion of its metabolite 2-thiothiazolidine-4-carboxylic acid (TTCA) were based on results from 403 personal air samples (352 passive and 51 active samples) and 362 TTCA determinations in biological material measured during a field study on the adverse effects due to CS2 exposure. The external exposure ranged from below the detection limit (0.2 ppm) to 66 ppm and the urinary TTCA excretion from below the detection limit (0.16 mg./l) to 33.4 mg/l. The excretion of TTCA in postshift urine related to creatinine and volume showed a linear correlation to the CS2 air concentration. On the basis of these results the influence on the internal exposure of physical work load, dermal exposure and individual parameters (age, Brocaindex, disturbed skin barrier) was evaluated. Correlations between the TTCA values in the postshift urine and the individually measured CS2 concentrations were carried out separately for individual departments and persons with and without indications of a disturbed skin barrier. In order to be able to judge the individual internal exposure related to external exposure, a personal quotient was formed from the TTCA level in the urine and the CS2 air concentration measured on the same day (relative internal exposure RIE index = TTCA mg/g creatinine/CS2 in ppm). On investigating interindividual differences, higher relative internal exposures were found in persons with a heavy physical work load and more intensive skin contact. It could be shown for a large group of persons exposed to CS2 that a pathological skin condition leads to an increase in the dermal penetration rate of hazardous substances.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

A test movie to study elementary abilities in perception and recognition of mimic and gestural expression.

A test movie consisting of 13 different silent movie scenes, each 10 s in duration, was developed to test in patients the elementary abilities, perception and recognition of mimic and gestural expression. Each scene was subjected to 10 (2 X 5) verbal or non-verbal multiple-choice tests. Quantitative analysis of normal control group results is described. All sub-tests were very easy for normals and resulted in error scores below 5%. Thus the test is not designed to differentiate within a group of normal subjects but to characterize a pathological reduction in mimic, gesture and person recognition in schizophrenic and brain-lesioned patients. By measuring the dependency of correct recognition of the different movie scenes on the inspection duration, it was shown that the projection time of 10 s applied in the full test led to a fairly high amount of informational redundancy. This was intentional so that stimulus material could be well perceived and recognized even by patients with somewhat fluctuating attentiveness.

Adult↗
PubMed2003

The opportunities and challenges of personalized genome-based molecular therapies for cancer: targets, technologies, and molecular chaperones.

There are now unprecedented opportunities for the development of improved drugs for cancer treatment. Following on from the Human Genome Project, the Cancer Genome Project and related activities will define most of the genes in the majority of common human cancers over the next 5 years. This will provide the opportunity to develop a range of drugs targeted to the precise molecular abnormalities that drive various human cancers and opens up the possibility of personalized therapies targeted to the molecular pathology and genomics of individual patients and their malignancies. The new molecular therapies should be more effective and have less-severe side effects than cytotoxic agents. To develop the new generation of molecular cancer therapeutics as rapidly as possible, it is essential to harness the power of a range of new technologies. These include: genomic and proteomic methodologies (particularly gene expression microarrays); robotic high-throughput screening of diverse compound collections, together with in silico and fragment-based screening techniques; new structural biology methods for rational drug design (especially high-throughput X-ray crystallography and nuclear magnetic resonance); and advanced chemical technologies, including combinatorial and parallel synthesis. Two major challenges to cancer drug discovery are: (1) the ability to convert potent and selective lead compounds with activity by the desired mechanism on tumor cells in culture into agents with robust, drug-like properties, particularly in terms of pharmacokinetic and metabolic properties; and (2) the development of validated pharmacodynamic endpoints and molecular markers of drug response, ideally using noninvasive imaging technologies. The use of various new technologies will be exemplified. A major conceptual and practical issue facing the development and use of the new molecular cancer therapeutics is whether a single drug that targets one of a series of key molecular abnormalities in a particular cancer (e.g. BRAF) will be sufficient on its own to deliver clinical benefit ("house of cards" and tumor addiction models). The alternative scenario is that it will require either a combination of agents or a class of drug that has downstream effects on a range of oncogenic targets. Inhibitors of the heat-shock protein (HSP) 90 molecular chaperone are of particular interest in the latter regard, because they offer the potential of inhibiting multiple oncogenic pathways and simultaneous blockade of all six "hallmark traits" of cancer through direct interaction with a single molecular drug target. The first-in-class HSP90 inhibitor 17AAG exhibited good activity in animal models and is now showing evidence of molecular and clinical activity in ongoing clinical trials. Novel HSP90 inhibitors are also being sought. The development of HSP90 inhibitors is used to exemplify the application of new technologies in drug discovery against a novel molecular target, and in particular the need for innovative pharmacodynamic endpoints is emphasized as an essential component of hypothesis-testing clinical trials.

Antineoplastic Agents↗
PubMed2005

Combined photodynamic therapy and intravitreal triamcinolone for the treatment of myopic choroidal neovascularization in a 13-year-old girl.

BACKGROUND: Combination photodynamic therapy with verteporfin (PDT) and intravitreal triamcinolone acetonide (IVT) is currently being investigated as a treatment for choroidal neovascularization (CNV) due to age-related macular degeneration. However, PDT with triamcinolone has never previously been described in the treatment of CNV secondary to pathologic myopia, or in a young person. We describe the case of a young girl treated with combination PDT and IVT for a myopic subfoveal CNV membrane. METHODS: This study was an interventional case report. The medical chart of a 13-year-old child treated with combination PDT with IVT was reviewed for changes in visual acuity on the ETDRS chart, CNV leakage on fluorescein angiography, and adverse events reported. RESULTS: ETDRS visual acuity improved from 20/80-2 to 20/25 in the right eye over 7 months following two treatments of a myopic CNV lesion with combination PDT and IVT. Following treatment, an inactive scar with no further leakage was visible on fluorescein angiography. An increase in intraocular pressure was associated with the second IVT treatment, and successfully treated with topical therapy. CONCLUSIONS: Combination PDT with IVT may be considered under appropriate circumstances to treat children with CNV.

Adolescent↗
PubMed1975

Observations on the electrocardiographic changes associated with subarachnoid hemorrhage with special reference to their genesis.

A 36 year old man presented with bizarre behavior and had abnormal electrocardiograms on two occasions. Because of ST-T wave changes, he was treated both times for a possible subendocardial infarction. A more complete evaluation during the second admission revealed a basilar artery aneurysm with subarachnoid hemorrhage as the cause of the central nervous system symptoms. While the aneurysm was successfully clipped, the patient's electrocardiogram was recorded. Several electrocardiographic changes characteristic of intracranial disease were observed during the procedure. These changes developed with distortion of the circle of Willis and reverted when such distortion stopped. We review the spectrum of the electrocardiographic changes associated with intracranial disease. This list of abnormalities was compiled from observations obtained by the impatient tracings of persons with various central nervous system pathology. The mechanisms used to explain the changes are based solely on work performed on laboratory animals. The results of our findings in our patient link electrocardiographic abnormalities directly with a central nervous system lesion.

Adult↗