[Thoughts on Orvosi Hetilap and other subjects. "Solvitur acris hiems..." (Horatius) (correction of Martialis)].
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Biomedical subjects
Publications and source records attributed to L Major.
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Based on recent computed tomography (CT) studies that have suggested the presence of distinct structural abnormalities in the brains of chronic schizophrenics, the authors evaluated 23 chronic schizophrenics and 23 controls by CT, using linear and area lateral ventricular measures, sulcal and Sylvian fissure widths and cerebral density measures. Technical problems inherent in CT studies and their impact on the use of data generated by such studies are discussed. Although there were few differences between groups, there emerged a distinct subgroup of schizophrenic patients with mild lateral ventricle enlargement associated with increased cortical density. The possible etiopathology for this atypical combination is discussed, including the striking parallels with a recent neuropathological study's findings.
There are numerous reports of lateral cerebral ventricle enlargement on computed tomography (CT) in schizophrenics, but the significance and its relationship to traditional notions of organicity remain unclear. Therefore we studied a subgroup of chronic schizophrenics who had lateral ventriculomegaly (and also cortical hyperdensity) on a battery of relevant biological, neuro-psychological, and clinical parameters such as electroencephalogram (EEG), platelet monoamine oxidase (MAO) and serum dopamine-beta-hydroxylase (DBH) activity, the Halstead Reitan Neuropsychological Battery (HRB), premorbid personality adjustment, drug response, positive and negative symptoms, employment history, and family history. Our findings support the notion that there is an "organic" subgroup of schizophrenia that has 1) CT structural abnormalities such as lateral ventricle enlargement and cortical hyperdensity; and cerebral dysfunction or deficits as evidenced by 2) an increased incidence of abnormal EEGs and also 3) greater impairment on neuropsychological tests. The biochemical measures, platelet MAO and serum DBH activity, nor any of the clinical measures could differentiate between the subgroups. The implications of these findings for the subtyping of schizophrenia are discussed.
Twenty-three chronic schizophrenic patients and 23 controls, all males between 20 and 40 years of age, were evaluated by CT scan. The lateral, third and fourth ventricles, the Sylvian fissures, and the largest sulcus from each of the frontal, parietal, and occipital lobes, were measured in order to determine whether the previously reported ventriculomegaly in schizophrenics was perhaps due to a disturbance of CSF flow or to atrophy, two common causes of ventricular enlargement. We found that in the schizophrenic group the third and fourth ventricles and both Sylvian fissures were significantly enlarged, but not the lateral ventricles or cerebral sulci. Our data suggest that these ventricular changes are not due to a disturbance of CSF flow or to cerebral atrophy. Other possible explanations are discussed.
Simple, objective, linear, and density measures were used to evaluate by computed tomography (CT) the cerebellum-fourth ventricular region of 23 chronic schizophrenic patients and 23 normal controls. Our data suggest that a subgroup of chronic schizophrenic patients have cerebellar atrophy associated with a strong but nonsignificant trend toward increased cerebellar density. The implications of these findings are discussed in view of previous CT and neuropathological studies.
Ureterectasia can be congenital (mega-ureter) or acquired (hydro-ureter). Mega-ureters can be of reflux and non-reflux (obstructive) type. The essence of primary non-reflux mega-ureters is the presence of a prevesical adynamic segment which causes functional obstruction. The musculature of this segment is abnormal in both function and structure. A surgical solution of the malformation is recommended mainly in children and young adults. In 10 years, 17 patients were subjected to 22 operations. After removal of the obstructive segment and straightening of the ureter, it was implanted into the vesicle through an intravesical tunnel. With the exception of two cases where nephrectomy had to be done and a case with persisting reflux, the other operations were successful. Narrowing of the ureter was not done. Ureteral neo-implantation is preferred to Boari's operation. Isolated pelvis ureters are operated only in the case of complications.
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