Clovis Vincent (1879-1947): founder of French neurosurgery and promoter of oncologic neurosurgery.

The eminent neurologist Clovis Vincent decided to become neurosurgeon at an advanced age. His is considered the founder of French neurosurgery and the Europe's first neurosurgeon. He was mainly interested in pituitary tumors and his work on oncologic neurosurgery remains valuable.

[Sexual mutilations through ages]. / Les mutilations sexuelles à travers les âges.

Among the ethnic mutilations (volunteer mutilations performed for religious, aesthetic, moral or hygienic purposes), genital mutilation (circumcision, castration, total emasculation, infibulation, excision, etc.) have always fascinated the human mind and are the subject of our historical overview.

The oncologic conceptions of the great clinician, phtisiologist, pathologist and statistician Gaspard-Laurent Bayle (1774-1816).

Gaspard-Laurent Bayle was a 19th century eminent clinician, pathologist, phthisiologist and statistician that deserves our attention. His very advanced oncologic conceptions rank him among the all-time great pioneers of oncology.

The Nobel Prize laureate - father of anaphylaxis Charles-Robert Richet (1850-1935) and his anticancerous serum.

Professor of physiology Charles-Robert Richet, winner of the Nobel Prize in 1913, is best known for his work on anaphylaxis. However, with his collaborator Jules Héricourt studied the effects of antibody treatment and made the very first attempts to fight cancer with serotherapy. Being versatile, Richet contributed in neurology, psychology and was also a poet, playwrighter, pacifist and pioneer in aviation.

Neurochemical variables in delusional depression.

The authors assayed plasma dopamine beta-hydroxylase activity, platelet monoamine oxidase (MAO) activity, plasma prolactin, the urinary monoamine metabolites 3-methoxy-4-hydroxyphenylglycol (MHPG), 5-hydroxyindoleacetic acid (5-HIAA), and homovanillic acid (HVA), and urinary cAMP from 18 delusional and 22 nondelusional depressed inpatients. No significant differences between the two groups were found.

Physical activity and plasma cyclic adenosine monophosphate levels in manic-depressive patients and healthy adults.

Intense exercise for one hour induced a significant increase in plasma cyclic adenosine monophosphate (cAMP) in 5 healthy volunteers. In 44 manic-depressive patients, cAMP levels correlated more strongly with mood ratings than with activity scores. The authors conclude that physical activity is one of the factors which contribute to changes of cAMP levels in affective illness.

Platelet monoamine oxidase and plasma dopamine-beta-hydroxylase activities in non-abstinent chronic alcoholics. Relation to clinical parameters.

Platelet monoamine oxidase (MAO) and plasma dopamine-beta-hydroxylase (DBH) activities were determined in 27 male non-abstinent chronic alcoholics. Compared to 24 normals, no significant difference in both enzyme activities was found. Alcoholics with at least one alcoholic first degree relative had a trend toward lower platelet MAO activity compared to those without such a history. Matched pair analysis showed that alcoholics of the former subgroup had significantly lower MAO activity than controls. Demented alcoholics had significantly reduced plasma DBH activity compared with the non-demented subgroup and with age, and sex, matched controls.

Type and content of delusions in unipolar psychotic depression.

In a prospective study the authors compared unipolar psychotic and non-psychotic patients for the presence of delusional ideation in previous episodes. Psychotic patients had a significantly higher frequency of delusions in previous episodes. The type and content of delusional ideas were similar from episode to episode. The results and their implications are discussed.

Histochemical changes of peripheral blood leukocytes during lithium treatment.

The effect of lithium on the histochemistry of blood granulocytes was studied in 16 manic-depressive patients during lithium prophylaxis. Blood smears obtained before, at 2 months and at 12 months after initiation of treatment showed that lithium caused condensation of the chromatin in granulocytes, conformation changes in eosinophilic granules and the disappearance of basic proteins found in the cytoplasm of eosinophils in the drug-free patients. The latter findings are interpreted as indicating the involvement of lithium in histamine metabolism.

Sleep deprivation psychoprophylaxis in recurrent affective disorders.

Administration of prophylactic 36 h total sleep deprivation to 9 manic-depressive patients (5 bipolar and 4 unipolar depressives) reduced the frequency of relapses and increased the duration of normothymia in 5 patients, left the course of illness unchanged in 3 patients whilst in 1 patient the effect could not be evaluated. Sleep deprivation appeared to be more effective in women, 'rapid cyclers', patients with a positive family history of mental illness and patients with recurrent depression. These observations confirm previous impressions and suggest a possible prophylactic effect of sleep deprivation.

Julius Wagner-Jauregg (1857-1940): Introducing fever therapy in the treatment of neurosyphilis.

For centuries, heat has been used in various ways for the cure of mental diseases. Hippocrates noted that malarial fever could have a calming effect in epileptics. Centuries later, Galen described a case of melancholy cured as a result of an attack of quartan fever. In 19th century, the eminent French psychiatrist Philippe Pinel, in his treatise on insanity referred to the beneficial effect of fever. An opinion expressed few years later by his pupil Jean-Étienne Dominique Esquirol in his treatise entitled Des maladies mentales considérées sous les rapports médical, hygiénique et médico-légal. However, in 1917, the Austrian neuro-psychiatrist Julius Wagner Jauregg pointed out the therapeutic value of malaria inoculation in the treatment of dementia paralytica. In 1927, Wagner Jauregg received for this work the Nobel Prize in Medicine, being actually the first psychiatrist to win the Nobel Prize. He studied medicine at the University of Vienna and received his doctorate in 1880. In 1889, he was appointed Professor of Psychiatry and Director of the Graz's Psychiatric Clinic, a position that he held until 1928. Working in the asylum, Wagner Jauregg noted that insane patients with general paralysis occasionally became sane after some febrile episode. After experimenting with several artificial methods (streptococci, tuberculin) to induce fever, he concluded that malaria was the most satisfactory. Actually, malaria infection was an acceptable risk for the patients, as quinine would be administered as soon as syphilis was cured. In 1917, he reported the first favorable results of his study. Patients were inoculated via intravenous injections with malaria. Some physicians were starting the administration of anti-syphilitic treatment (bismuth, salvarsan and later penicillin) after 10-12 febrile paroxysms, while others initiated the regimen the first febrile-free day after 8 malarial paroxysms. The therapeutic regimen was completed with the administration of quinine sulfate to terminate the malaria infection. It is worth mentioning that the above treatment was followed in hospital under strict monitoring of patients' vital signs and regular laboratory tests. In the following years of his discovery, artificial fever was induced by any one of the following methods: the introduction into the patient of a parasitic disease; the injection of a foreign protein; injections of chemical substances such as sulphur; electrical means such as the administration of diathermy or radiotherapy, or placing the patient in an electromagnetic field; and simple immersion of the individual in a hot bath, or placing him in a heat cabinet. Wagner Jauregg's therapy was highly admired and was used on neurosyphilis cases well onto the 1950's. However, with the introduction of penicillin in syphilis' treatment, fever therapy effectively ended. Wagner Jauregg's study led to all the methods of stress therapy used in psychiatry, as electric shock, and insulin.

[Reliability and validity of the Greek version of the Alcohol Use Disorders Identification Test (AUDIT)].

Problems associated with alcohol abuse are recognised by the World Health Organization as a major health issue. Because of the size and severity of the problem, early detection is very important.This requires easy to use and specific tools. One of these is the Alcohol Use Disorders IdentificationTest (AUDIT). AUDIT was translated and back-translated from its original language by two Englishspeaking psychiatrists. The tool contains 10 questions. A score ≥11 is an indication of serious abuse/dependence. In the study, 218 subjects took part: 128 were males and 90 females. From the218 individuals, 109 fulfilled the criteria for alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), and presented requesting admission; 109 subjects were healthy controls. Internal reliability (Cronbach a) was 0.80 for the controls and0.80 for the alcohol dependent individuals. Controls had significantly lower average scores when compared to the alcoholics. The questionnaire's sensitivity for scores >8 was 0.98 and its specificity was 0.94 for the same score. Ιn conclusion, the Greek version of AUDIT has increased internalreliability and validity and is easy to use and can be very useful in detection alcohol problems in sensitive populations.

Attitudes on euthanasia and physician-assisted suicide among medical students in Athens.

Attitudes towards assisted death activities among medical students, the future health gatekeepers, are scarce and controversial. The aims of this study were to explore attitudes on euthanasia and physician-assisted suicide among final year medical students in Athens, to investigate potential differences in attitudes between male and female medical students and to review worldwide attitudes of medical students regarding assisted death activities. A 20- item questionnaire was used. The total number of participants was 251 (mean age 24.7±1.8 years). 52.0% and 69.7% of the respondents were for the acceptance of euthanasia and physician-assisted suicide, respectively. Women's attitudes were more often influenced by religious convictions as well as by the fact that there is a risk that physician-assisted suicide might be misused with certain disadvantaged groups. On the other hand, men more often believed that a request for physician-assisted suicide from a terminally ill patient is prima-facie evidence of a mental disorder, usually depression. Concerning attitudes towards euthanasia among medical students in various countries there are contradictory results. In USA, the Netherlands, Hungary and Switzerland most of the students supported euthanasia and physician-assisted suicide. However, in many other countries such as Norway, Sweden, Yugoslavia, Italy, Germany, Sudan, Malaysia and Puerto Rico most students expressed negative positions regarding euthanasia and physician assisted suicide.

Recurrence risk for the relatives of delusional depressed patients.

The recurrence risks for major depression among the relatives of patients with delusional depression have been calculated using a computer program. The risk tables have been based on the data from the 454 first-degree relatives of 77 probands with delusional depression, the 503 first-degree relatives of 76 non-delusional probands and the 980 first-degree relatives of 153 controls. The results showed that: the familial aggregation of the delusional depression seem to follow the multifactorial pattern of inheritance (segregation analysis), the heritability of the delusional depression was found to be 62, the recurrence risk varies from 0.5% to 36.2% for the various relatives and tables for recurrence risks are provided.

Platelet monoamine oxidase, plasma dopamine beta-hydroxylase activity, dementia and family history of alcoholism in chronic alcoholics.

The authors measured platelet monoamine oxidase (MAO) activity and plasma dopamine beta-hydroxylase activity in 36 male chronic alcoholics during a period of non-abstinence, and in 29 normal controls. The influence of family history, dementia, chronicity of drinking and liver injury on the enzyme activities was also examined by multiple regression analysis. Platelet MAO was significantly lower in the alcoholic group. Both enzyme activities were negatively related to the presence of dementia, while low MAO activity was associated with positive family history (parents, sibs) of alcoholism.

Abrupt lithium discontinuation in manic-depressive patients.

Prophylactic lithium was abruptly discontinued (under double-blind conditions and using placebo) in 18 manic-depressive patients for 15 days. Following lithium withdrawal tremor of hands, polyuria, general muscular weakness, polydipsia and dryness of mouth were significantly reduced. No withdrawal symptoms were noted. Three patients relapsed within 4 days of lithium discontinuation. The questions arising from these findings are discussed and the possibility of a rebound phenomenon produced by lithium is considered.

Subtypes of schizophrenia and ABO blood types.

Determination of ABO blood types was carried out in 430 (171 female and 259 male) patients with hebephrenic schizophrenia and in 340 (155 female and 185 male) patients with paranoid schizophrenia. Results were compared with a random sample of 600 individuals (268 female and 332 male) drawn from the general population. No significant association was detected between any of the ABO blood phenotypes and affliction either with hebephrenic or paranoid schizophrenia