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.

DNA Polymorphisms: What They Are and Their Role in Human Pigmentation / Poliformismos de ADN: Qué son y su rol en la pigmentación

The color of the skin, hair and eye is controlled by multiple genes and is among the most visible examples of human phenotypic variation. Genetics correlate phenotypic with genotypic variation. Recent scientific work reveals DNA polymorphisms at least partially responsible for some of the differences observed in human pigmentation. These are the focus of this review (AU)

El color de la piel, el pelo y los ojos está controlado por múltiples genes y es uno de los ejemplos más visibles de la variabilidad fenotípica humana. La genética correlaciona la variabilidad fenotípica con la genotípica. Recientes publicaciones científicas revelan que los polimorfismos del ADN son responsables, al menos parcialmente, de algunas de las diferencias observadas en la pigmentación humana. Éstas serán el objetivo de la presente revisión (AU)

DNA polymorphisms: what they are and their role in human pigmentation.

The color of the skin, hair and eye is controlled by multiple genes and is among the most visible examples of human phenotypic variation. Genetics correlate phenotypic with genotypic variation. Recent scientific work reveals DNA polymorphisms at least partially responsible for some of the differences observed in human pigmentation. These are the focus of this review.

Fibroadenoma masquerading carcinoma on fine-needle aspiration of the breast.

OBJECTIVE: Benign and malignant lesions of the breast may have similar appearances on fine-needle aspiration cytology. We report a case of fibroadenoma that was diagnosed as carcinoma by cytology. CASE STUDY: Breast fine-needle aspiration biopsy was highly cellular and composed of bland-appearing spindle/columnar cells that could represent either epithelial or stromal cells; the case was reported as positive and the patient had subsequent excisional biopsy taken. RESULTS: On microscopic examination, smears were hypercellular and had many single cells and clusters of columnar/ elongate cells No obvious bipolar cells of myoepithelial origin were seen. Significant atypia was noted. Immunocytochemistry for smooth muscle actin was not performed due to insufficient material. CONCLUSIONS: Some cases of fibroadenoma and carcinoma can be very difficult to distinguish on fine needle aspiration cytology smears. Immunocytochemistry may be of help if sufficient material is provided. To avoid false positive diagnosis on cytology, it is best to report such a case as intermediate (atypical/suspicious) with final interpretation pending excisional biopsy.

Cell proliferation and DNA fragmentation (apoptosis) on FNABs of breast invasive ductal carcinomas and their relationship to clinicopathological variables and prognosis.

The purpose of this study was to investigate cell proliferation and apoptosis in ductal breast invasive carcinomas and their relationship to prognosis. Fifty cases, from the same number of operable female patients, were diagnosed cytologically on FNA biopsies as invasive ductal breast carcinomas and confirmed histologically after oncectomy. In the same cases, to evaluate the cell proliferation and apoptosis, the MIB1 and the TUNEL method were used respectively. Furthermore the relationship between proliferative activity and apoptosis to other factors such as menopausal status, tumor size, axillary lymph node status and tumor grade was studied. Cell proliferation and apoptosis were found to be significantly related to the menopausal status of the patients (p < 0.001) and to the grade of the tumor (p < 0.01), while no significant relationship to axillary lymph node status and tumor size was found.