Oswald Schmiedeberg (1838-1921) : Ninth Pharmacologic­Historical Forum, 2024, Munich, Germany.

Oswald Schmiedeberg was born in one of the former Baltic provinces of Russia. He studied medicine in Dorpat (Tartu) and joined the Institute of Pharmacology of Rudolf Buchheim in Dorpat. After promotion (1866) and habilitation (1868), he succeeded Buchheim as director of the institute. During this time, he further developed the experimental methods leading to the improvement of pharmacological knowledge introduced by Buchheim. In 1872, he became director of the Institute of Pharmakologie of the newly founded Kaiser-Wilhelm University in Strasbourg. He held this position for over 42 years until the end of the World War 1 when all Germans had to leave the former Reichsland Elsass-Lothringen. He settled next to his friend and colleague Naunyn in Baden-Baden, where he died in 1921. Holmstedt and Liljestrand's (1963) History of Pharmacology and Toxicology noted, "Schmiedeberg was undoubtedly the most prominent pharmacologist of his time." He had about 120 pupils, about 40 of them occupied pharmacology chairs throughout the world. In the USA, John Jacob Abel, after his return to the USA, became the "father of American pharmacology". In 1873, Schmiedeberg, together with the pathologist Klebs (Prague) and the clinician Naunyn (Königsberg), founded the Archiv für experimentelle Pathologie und Pharmakologie. When Naunyn died in 1925, the periodical was named Naunyn-Schmiedeberg's Archiv, from volume 110 onwards. In 1969, the designation "experimental pathology" was dropped, since nearly all papers submitted for some time past dealt with pharmacology. In 1883, Schmiedeberg published the Grundriss der Arzneimittellehre, the later edits with the title Grundriss der Pharmakologie in Bezug auf Arzneimittellehre und Toxikologie.

Edvard Munch's crisis in 1908 and French medicine: His doctors, treatments, and sources of information.

In 1908, Norwegian artist Edvard Munch-already famous for The Scream and other paintings showing sickness, despair, and suffering-put himself under the care of Dr. Daniel Jacobson, a nerve doctor in Copenhagen. Jacobson had previously attended some of Jean-Martin Charcot's lectures in Paris, as had Knud Pontoppidan, his mentor. Munch, in turn, had long been showing signs and symptoms of an anxiety disorder and what might have been viewed as neurasthenia or hysteria. Now, he also seemed to be suffering from acute alcoholic toxicity. In this article, we explore Scandinavian psychiatry at the turn of the century; Jacobson and Pontoppidan's connections to Paris; and how some of Munch's treatments, most notably his electrotherapy sessions, related to therapeutics at La Salpêtrière. Additionally, various ways in which Munch learned about French medicine are examined. This material reveals how well-known and influential Charcot and his ideas about disorders of the brain and mind had become at the turn of the century, affecting not just the French physicians but also a world-famous artist and his nerve doctor in Scandinavia.

Berger and the Breakthrough: A Centennial Celebration of the Human Electroencephalogram.

A century ago, it was a challenge for neuroscientists to decipher the mysteries of human brain functioning until German psychiatrist Hans Berger discovered what is now one of the most well-known electrophysiological recording techniques to examine brain function, EEG. He is rightly regarded as the Father of The Electroencephalogram (EEG), since he performed the first human electroencephalogram in 1924. Berger attempted to investigate the connection between psychology and physiology and to solve the "psychic energy" enigma. Despite turbulence in his professional life and slow progress in his research, he persevered and succeeded in giving humankind an indispensable technique that is now widely used in clinical and research practice. His publications on EEG provide valuable insight into our current understanding of several of the brain's responses to physiological and pathological phenomena. In July 2024, it will be 100 years since Berger recorded the first human EEG, and that calls for a celebration among EEG researchers, neuroscientists, psychiatrists, and neurologists. This article presents a brief account of his journey and commemorates Hans Berger's contributions to the field of neurodiagnostics.

Lean body mass and the cardiorespiratory phenotype: An ethnic-specific relationship in Hans Chinese women and men.

BACKGROUND: Lean body mass (LBM) and the functional capacity of cardiovascular (CV) and respiratory systems constitute a female-specific relationship in European-American individuals. Whether this recent finding be extrapolated to the world's largest ethnic group, that is, Hans Chinese (HC, a population characterized by low LBM), is unknown. METHODS: Healthy HC adults (n = 144, 50% ♀) closely matched by sex, age and physical activity were included. Total and regional (leg, arm and trunk) LBM and body composition were measured via dual-energy X-ray absorptiometry. Cardiac structure, stiffness, central/peripheral haemodynamics and peak O2 consumption (VO2peak) were assessed via transthoracic echocardiography and pulmonary gas analyses at rest and during exercise up to peak effort. Regression analyses determined the sex-specific relationship of LBM with cardiac and aerobic phenotypes. RESULTS: Total and regional LBM were lower and body fat percentage higher in women compared with men (P < 0.001). In both sexes, total LBM positively associated with left ventricular (LV) mass and peak volumes (r ≥ 0.33, P ≤ 0.005) and negatively with LV end-systolic and central arterial stiffness (r ≥ -0.34, P ≤ 0.004). Total LBM strongly associated with VO2peak (r ≥ 0.60, P < 0.001) and peak cardiac output (r ≥ 0.40, P < 0.001) in women and men. Among regional LBM, leg LBM prominently associated with the arterio-venous O2 difference at peak exercise in both sexes (r ≥ 0.43, P < 0.001). Adjustment by adiposity or CV risk factors did not modify the results. CONCLUSIONS: LBM independently determines internal cardiac dimensions, ventricular mass, distensibility and the capacity to deliver and consume O2 in HC adults irrespective of sex.

Celebrating the centennial of the most famous experiment in embryology: Hilde Mangold, Hans Spemann and the organizer.

This Issue of Cells & Development celebrates the centennial of the Spemann-Mangold organizer experiment. This was the most famous experiment in embryology and its reverberations have greatly influenced developmental biology. This historical issue describes the impact of the discovery and is a prelude to the second volume of this Festschrift, which will consist of the proceedings of the international meeting to be held in Freiburg University, at the place where the organizer was discovered.

On the Pelletier and Caventou (1817, 1818) papers on chlorophyll and beyond.

The first use of the word 'chlorophyll' (chlorophile or chlorophyle in the French original) appeared in two papers by Pierre-Joseph Pelletier and Joseph Bienaimé Caventou, pharmacists in Paris who isolated and studied the green pigment from plants. Here, we provide English translations of their 1818 note and the slightly longer 1817 paper. Historical context is provided including a timeline of key discoveries in chlorophyll chemistry pertaining to photosynthesis.

The Chinese cardiorespiratory and circulatory system at work in women and men: a case-control study.

Background: The physiology of prominent prognostic factors in the cardiorespiratory system remains unchartered in the world's largest ethnic group: Hans Chinese (HC). This study assessed and contrasted the fundamental variables in HC and European-American (EA) individuals. Methods: Healthy HC and EA adults (n = 140, 43% ♀) closely matched by age, sex and physical activity were included. Body composition (DXA) and haematological variables (haemoglobin mass, blood volume (BV)) were measured at rest. Pulmonary O2 uptake (VO2) measurements along with cycle ergometry designed for accurate transthoracic echocardiography were implemented to assess cardiorespiratory structure/function up to peak effort. Findings: HC presented with higher body fat and lower lean body mass (LBM) percentage than EA irrespective of sex (P ≤ 0.014). BV did not differ whereas blood haemoglobin concentration was lower in HC compared with EA, particularly in females (P = 0.009). Myocardial diastolic and overall function at rest was enhanced in HC versus EA (P < 0.001). During exercise, heart volumes and output per unit of body size did not differ between ethnicities, whereas larger heart volumes per unit of LBM were found in HC versus EA in females (P ≤ 0.003). At high exercise intensities, VO2 (-16%) and the arteriovenous O2 difference (-28%) were markedly reduced in HC compared with EA in females (P ≤ 0.024). In males, no physiological difference between HC and EA was observed during exercise. Interpretation: Notwithstanding lower LBM, HC are characterised by similar BV and cardiac capacity but reduced peak VO2 than EA in females, partly explained by low ethnic-specific blood O2 carrying capacity. Funding: Early Career Scheme (106210224, to D.M.) and Seed Fund (104006024, to D.M.).

Erica L. (Ericaceae): homonyms amongst published names for African species and proposed replacement names.

In support of ongoing taxonomic work on the large and complex flowering plant genus Erica (Ericaceae), we document nineteen pairs of homonyms representing currently used illegitimate names. We provide replacements for thirteen names and new typifications for five. We relegate five names to synonymy: Ericaaemula Guthrie & Bolus under Ericadistorta Bartl.; Ericaarmata Klotzsch ex Benth. under Ericaumbrosa H. A. Baker; Ericacapensis T.M. Salter under Ericaturbiniflora Salisb.; Ericalanata Andrews under Ericaflaccida Link; and Ericatomentosa Salisb. under Ericavelutina Bartl. Finally, we suggest conservation of Ericaaristata Andrews. The new names are: Ericaadelopetala E.C. Nelson & E.G.H. Oliv. replacing Ericainsignis E.G.H. Oliv.; Ericabombycina E.C. Nelson & Pirie replacing Ericaniveniana E.G.H. Oliv.; Ericaconcordia E.C. Nelson & E.G.H. Oliv. replacing Ericaconstantia Nois. ex Benth.; Ericadidymocarpa E.C. Nelson & E.G.H. Oliv. replacing Ericarugata E.G.H. Oliv.; Ericagalantha E.C. Nelson & E.G.H. Oliv. replacing Ericaperlata Benth.; Ericamallotocalyx E.C. Nelson & E.G.H. Oliv. replacing Ericaflocciflora Benth.; Ericanotoporina E.C. Nelson & E.G.H. Oliv. replacing E.autumnalis L.Bolus; Ericaoliveranthus E.C. Nelson & Pirie replacing Ericatenuis Salisb.; Ericaoraria E.C. Nelson & E.G.H. Oliv. replacing Ericaspectabilis Klotzsch ex Benth.; Ericaoresbia E.C. Nelson & E.G.H. Oliv. replacing Ericademissa Klotzsch ex Benth.; Ericapoculiflora E.C. Nelson & E.G.H. Oliv. replacing Ericastenantha Klotzsch ex Benth.; Ericarhodella E.C. Nelson & E.G.H. Oliv. replacing Ericarhodantha Guthrie & Bolus; Ericasupranubia E.C. Nelson & Pirie replacing Ericapraecox Klotzsch.

Removal of disinfection byproducts through integrated adsorption and reductive degradation in a membrane-less electrochemical system.

Proper control/removal of disinfection byproducts (DBPs) is important to drinking water safety and human health. In this study, a membrane-less electrochemical system was developed and investigated to remove DPBs through integrated adsorption and reduction by granular activated carbon (GAC)-based cathode. Representative DPBs including trihalomethanes and haloacetonitriles at drinking water concentrations were used for removal experiments. The proposed system achieved >70% removal of most DBPs in a batch mode. The comparison with control tests under either open circuit or hydrolysis demonstrated the advantages of electrochemical treatment, which not only realized higher DPBs removal but also extended GAC cathode lifetime. Such advantages were further demonstrated with continuous treatment. High dechlorination and debromination efficiencies were obtained in both batch (82.2 and 94.3%) and continuous (79.3 and 87.6%) reactors. DBPs removal was mainly contributed by the electrochemical reduction and adsorption by the GAC-based cathode, while anode showed little oxidizing effect on DBPs and halide ions. Dehalogenated products of chloroform and dichloroacetonitrile were identified with toxicity reduction. The energy consumption of the continuously operated system was estimated to be 0.28 to 0.16 kWh m-3. The proposed system has potential applications for wastewater reuse or further purification of drinking water.

Hans Hugo Bruno Selye y el estrés, hito en la historia de la Medicina moderna / Hans Hugo Bruno Selye and the stress, a milestone in the modern medical history

Fundamento: Hans Hugo Bruno Selye, fisiólogo y médico austrohúngaro nació el 26 de enero de 1907, posteriormente se naturalizó canadiense, este hombre que vivió 75 años y llegó a ser director del Instituto de Medicina y Cirugía Experimental de la Universidad de Montreal, Canadá, hasta su retiro en 1970. Falleció en 1982, en esa misma ciudad. Objetivo: Describir la vida y obra del ilustre académico Hans Hugo Bruno Selye y la historia del estrés como hito en la historia de la Medicina moderna. Metodología: Se realizó un estudio retrospectivo de corte histórico donde se utilizaron métodos teóricos como el análisis documental y el histórico-lógico. Desarrollo: El doctor empezó a desarrollar su famosa teoría acerca de la influencia del estrés en la capacidad de las personas para enfrenarse o amoldarse a las consecuencias de lesiones o enfermedades en el segundo año de sus estudios de Medicina (1926). Esta investigación le permitió descubrir que los pacientes con variedad de dolencias manifestaban síntomas similares, los cuales podían ser atribuidos a los esfuerzos del organismo para responder a esta condición de estar enfermo. Él llamó a este conjunto de síntomas síndrome del estrés o síndrome de adaptación general (GAS). Conclusiones: Este médico es una de las personalidades más importantes de la historia de la Medicina; su teoría del estrés proporcionó un marco conceptual transcendental para cuestiones posteriores de los mecanismos y manifestaciones de las reacciones del mismo.

Background: Hans Hugo Bruno Selye, Austro-Hungarian physiologist and physician, born January 26, 1907, later naturalized Canadian citizen, this man who lived 75 years and became the Director of Experimental Medicine and Surgery Institute of Montreal University in Canada, until his retirement in 1970. He passed away in 1982, in the same city. Objective: Describe the life and achievements of the distinguished academic Hans Hugo Bruno Selye and the history of stress as a milestone in modern medical history. Methodology: A historical retrospective study was conducted using theoretical methods such as documental and historical-logical analysis. Methodology: The doctor began to build his famous theory about the influence of stress on the ability of persons to cope or adjust to the injury or illness consequences in the second year of his medical studies (1926). He discovered with this investigation that patients with a variety of ailments exhibited similar symptoms, which could be attributed to the organism efforts to respond to the condition of being sick. He named this set of symptoms stress syndrome or general adaptation syndrome (GAS). Conclusions: This physician is one of the greatest personalities in medical history; his stress theory provided a transcendental conceptual framework for later issues of the mechanisms and manifestations for stress reactions.

Value of GCET1, HGAL (GCET2), and LMO2 in the Determination of Germinal Center Phenotype in Diffuse Large B-cell Lymphoma

Objective: Diffuse large B-cell lymphoma (DLBCL) is a biologically heterogeneous disease that is classified into germinal center B-cell (GCB) and non-GCB subtypes, which are prognostically different. The Hans algorithm is the most widely used tool based on CD10, BCL6, and MUM1 expression, but some cases with the non-GCB phenotype are still known to be misclassified. In this study, we investigate the extent to which GCET1, HGAL, and LMO2 protein expressions reflect GCB phenotype together with their roles in determining the GCB phenotype of DLBCL and their contributions to the performance of the Hans algorithm. Materials and Methods: Sixty-five cases of DLBCL-not otherwise specified, 40 cases of follicular lymphoma (FL), and 19 non-GC-derived lymphoma cases were included in this study. The DLBCL cases were grouped as CD10+ (Group A) or only MUM1+ (Group B), and the remaining cases constituted the intermediate group (Group C). GCET1, HGAL, and LMO2 expressions were evaluated. Results: In the FL group, GCET1, HGAL, and LMO2 were positive in 85%, 77.5%, and 100% of the cases, respectively. Among the non-GC-derived lymphoma cases, all three markers were negative in cases of small lymphocytic lymphoma, plasmablastic lymphoma, peripheral T-cell lymphoma, and anaplastic large cell lymphoma. GCET1 and HGAL were negative in cases of marginal zone lymphoma (MZL) and mantle cell lymphoma (MCL). Two of the 3 MZL and 2 of the 4 MCL cases were positive for LMO2. In the DLBCL group, the number of cases with GCET1, HGAL, and LMO2 positivity was 18 (90%), 17 (85%), and 20 (100%), respectively, in Group A and 0 (0%), 2 (13.3%), and 2 (13.3%), respectively, in Group B. Considering these rates, when the cases in the intermediate group were evaluated, it was concluded that 13 cases typed as non-GCB according to the Hans algorithm may have the GCB phenotype. Conclusion: GCET1, HGAL, and LMO2 are highly sensitive markers for determining the germinal center cell phenotype and can increase the accuracy of the subclassification of DLBCL cases, especially for cases that are negative for CD10.

Evaluation of Nicotine Dependence Among Smokeless Tobacco Users Using the Fagerstrom Nicotine Dependence Scale for Smokeless Tobacco.

Nicotine dependence is a current indwelling and challenging health burden among smokeless tobacco users as it involves the compulsive use of a substance despite its known harmful effects. The evaluation of nicotine dependence is challenging as it involves physical and psychological dependence due to nicotine in smokeless tobacco. AIM AND OBJECTIVE: The primary aim is to assess the nicotine dependence in a group of smokeless tobacco by using a six-question Fagerstrom Test for Nicotine Dependence for Smokeless Tobacco (FTND-ST) and to assess the nicotine dependence among three groups, namely Group - 1, who were exclusively pan masala, gutka chewers, Group - 2, who were exclusively Hans users, and Group - 3, who were exclusively betel quid with smokeless tobacco chewers. MATERIALS AND METHODS: Only those who use smokeless tobacco in the age groups between 21 to 70 years were randomly selected. The total sample size is 100 patients. The age groups were divided into 21-28, 29-35, 36-42, 43-49, 50-56, 57-63, and 64-70. Informed consent was obtained from the participants of the study. RESULTS: The Hans chewers are predominantly females. Pan masala and gutka chewers are predominantly males. CONCLUSION: Smokeless tobacco chewers like pan masala were found to have high mean nicotine dependence Fagerstrom score than Hans and betel quid with smokeless tobacco chewers.

A Gadamerian approach to nursing: Merging philosophy with practice.

Philosophy is commonly criticized for being too abstract and detached from practical spheres. Upon chronicling how philosophy has gained this reputation, the authors explore the philosophical fields of phenomenology and hermeneutics that have explicitly attempted to merge philosophy with everyday life contexts. In recent decades, phenomenology and hermeneutics have been applied to healthcare. In the realm of nursing, Patricia Benner's nursing theory is especially informed by phenomenology, which is briefly explored through her relationship with one of her mentors, the philosopher Hubert Dreyfus. The authors then turn their attention to Hans-Georg Gadamer's philosophy in an attempt to mine concepts relevant to the practice of nursing. Gadamer juxtaposed the human sciences from the natural sciences and thought that both needed different approaches: whereas natural sciences are guided by episteme, that is, universal knowledge, human sciences are guided by phronesis, that is, practical wisdom. Gadamer's philosophy is especially helpful in understanding how to cultivate phronesis in nursing wherein a nurse relies upon one's clinical experience to masterfully navigate each unique patient relationship. Nurses must serve as authorities in the realm of healthcare but also be open to the authority of their patients, who ultimately choose their course of treatment in our contemporary era of patient autonomy. Gadamer's philosophy can help us understand why phronesis requires not only practice but also reflection on that practice to be appropriately cultivated. The authors apply this to the realm of nursing in showing how both practice-clinically and via simulation-and reflection-through journaling or dialogue-are necessary for phronesis to emerge.

The post-COVID stress syndrome: from the three-stage stress response of Hans Selye to COVID-19.

Stress is the nonspecific response of the body to any demand made upon it, as defined by Hans Selye more than 80 years ago, based on his animal experiments at McGill University in Montreal, Canada. By emphasizing 'nonspecificity' he tried to underline that stress response is elicited my several factors, like nowadays in COVID-19, e.g., fear of infection, social isolation, death in family, loss of employment, etc. Thus, COVID-19 has been the largest new human stressor in the twenty-first century. Selye's studies in rats also revealed 3 stages of stress response: the short initial "alarm reaction" is followed by a longer "stage of resistance", associated with increased levels of corticosterone that is often terminated by a "stage of exhaustion", referring to an exhausted adrenal cortex when the secretion of glucocorticoids drops. Fast forward, that is exactly what has been documented in severe cases of infections caused by the SARS-CoV-2 virus: in hospitalized COVID-19 patients initially the blood levels of cortisol not only have been elevated, but only those with high concentration of this natural anti-inflammatory corticosteroid survived vs. those who had low levels of cortisol, suggesting diminished adrenocortical functions. Furthermore, patients with very severe cases of COVID-19 who ended up in intensive care units had significantly low cortisol blood levels, compared to patients with equal severity of diseases due to other causes. Thus, these 'natural phenomena' in clinical medicine, unfortunately confirmed Selye's studies in experimental animals several decades ago. Still, the good news is that astute clinicians empirically recognized this and started to give potent synthetic glucocorticoids such as dexamethasone to severe COVD-19 patients and this beneficial effect of exogenous corticoids has been extensively confirmed in the scientific literature.

[Honors granted by the German Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (DGKJP) and its predecessors]. / Die Ehrungen der Deutschen Gesellschaft für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie e. V. (DGKJP) und ihrer Vorgängerorganisationen.

Honors granted by the German Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (DGKJP) and its predecessors Abstract. Abstracts: This research on the "honors" granted by the German Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (DGKJP) investigated all persons honored by the society from 1950 (following the postwar reestablishment of the society) up through 1990 (German reunification). We explored the adequacy of the honors regarding the professional ethics of the honorees during the NS-regime. Ethics violations included so-called T4-assessments (euthanasia) leading to death, working in "special units" where children were murdered using drugs, or any form of nontherapeutic experiments on humans. The Heinrich Hoffman Medal was first awarded in 1957, with honorary memberships being conferred from 1963 onward. From 1957 to 1990, the DGKJP awarded 19 honorary memberships and 9 Heinrich Hoffman Medal to 27 recipients (one person received both). Of those honored, three were detected as violators of professional ethics. After long internal discussions, the DGKJP had already distanced itself from Elisabeth Hecker (1895-1986), Hans-Alois Schmitz (1899-1973), and Werner Villinger (1887-1961). The ideology shared by these three was formulated by Villinger as the "ineducability" of their child victims because of an "inferiority paradigm." The rejection by the DGKJP went little noticed in public, and until 2021 was only briefly mentioned in the society's newsletter. Eleven honored persons were former members of the NSDAP without demonstrable ethical transgressions; the investigations are still ongoing for three others, whose ethical transgressions have neither been ruled out nor confirmed.

A função da mancha no caso Hans: da falta à presença do objeto / La función de la mancha en el Juanito: de la falta a la presencia del objeto / The function of the stain in little Hans: from lack to presence of the object / La fonction de la tache dans le petit Hans: du manque à la présence de l'objet

O artigo desenvolve a hipótese de que o trabalho de releitura do caso Hans, realizado por Lacan no Seminário 4, A relação de objeto (1956-1957), antecipa a formulação do conceito de objeto a em seu ensino. Dois pontos cruciais em relação ao objeto são destacados em um trabalho de leitura próxima e atenta ao texto do Seminário. Nesse percurso, a introdução da falta de objeto, modulada pelas operações de privação, frustração e castração, se contrapõe à noção de uma certa presença do objeto. O artigo propõe que em sua teorização sobre a angústia do pequeno Hans, Lacan introduz a função da mancha operando como objeto a, situando-a como um resíduo impossível de ser simbolizado, a coisa preta na boca do cavalo, objeto da fobia de Hans

El artículo desarrolla la hipótesis de que la relectura del caso Juanito realizada por Lacan en el Seminario 4, La relación de objeto (1956-1957) presenta una primera versión del concepto de objeto a en su enseñanza. Del trabajo de lectura cercana del texto del Seminario se destacan dos puntos cruciales con relación al objeto. En este recorrido, la introducción de la falta de objeto, modulada por las operaciones de privación, frustración y castración, admite la noción paradójica de una cierta presencia del objeto. El artículo propone que, a partir del desarrollo de su teorización sobre la angustia del Juanito, Lacan introduce la función de la mancha operando como objeto a, ubicándola como un residuo imposible de simbolizar, la cosa negra en la boca del caballo, objeto de la fobia de Juanito

The article develops the hypothesis that the re-reading of little Hans, carried out by Lacan in Seminar 4, The Object Relation (1956-1957), presents a primary version of the objet petit a in his teaching. In this course, two crucial points concerning the object are emphasized in a close reading of the Seminar's text. The introduction of the notion of lack of object, modulated by the operations of deprivation, frustration and castration, is then opposed to the notion of a certain presence of the object. The article proposes that with the development of a theorization on little Hans' anxiety, Lacan introduces the function of the stain working as na object a, a residue impossible to be symbolized, located in the black spot in the horse's mouth, object of Hans' phobia

L'article développe l'hypothèse qui la relecture du cas le petit Hans effectuée par Lacan dans le Séminaire 4, La relation d'objet(1956-1957) anticipe la formulation du concept d'objet (a) dans son enseignement. Deux points cruciaux par rapport à l'objet sont mis en évidence dans un travail de lecture attentive du texte du Séminaire. Dans ce parcours, l'introduction de la notion de manque d'objet, modulée par les opérations de privation, frustration et castration, s'oppose à la notion d'une certaine présence de l'objet. L'article soutient qui depuis sa théorisation sur l'angoisse du petit Hans, Lacan introduit la fonction de la tache comme un résidu impossible à symboliser, la chose noire dans la bouche du cheval, objet de la phobie de Hans. Et comme tel, la tache noire opère la fonction d'(a)

The multilobated morphology is still a better prognosis factor of diffuse large B-cell lymphoma in the R-CHOP era.

Diffuse large B-cell lymphoma (DLBCL) is the most common type of B-cell lymphoma. Although the multilobated subtype of DLBCL has been observed since the 1970s, little is known about the clinical significance of this unique variant in the era of rituximab, cyclophosphamide, hydroxydaunorubicin, oncovin, prednisone/prednisolone (R-CHOP) therapy. In this study, the retrospective clinicopathological analysis of 312 patients diagnosed with DLBCL showed that the multilobated DLBCL group comprised 11% of the cases and was predominantly male (p = 0.027), achieved complete remission in the first therapy (p = 0.023), and exhibited germinal center B-cell phenotypes in the Hans algorithm (p = 0.025). The multilobated DLBCL groups had a better prognosis in overall survival (OS) and progression-free survival (PFS) than the non-multilobated DLBCL group (OS, p = 0.006; PFS, p = 0.010). In the multivariate Cox regression analyses for OS, independent prognosis factors were high soluble IL-2 receptor (p = 0.025), high risk of International Prognostic Index, and multilobated morphology (p = 0.031). The most characteristic copy number gains found in more than 50% of the cases were located at 1q, 3p, 10q, 12q, and 14q. Overall, the multilobated morphology in DLBCL exhibits a good outcome in the R-CHOP era.

Routine application of the Lymph2Cx assay for the subclassification of aggressive B-cell lymphoma: report of a prospective real-world series.

The subclassification of diffuse large B-cell lymphoma (DLBCL) into germinal center B-cell-like (GCB) and activated B-cell-like (ABC) subtypes has become mandatory in the 2017 update of the WHO classification of lymphoid neoplasms and will continue to be used in the WHO 5th edition. The RNA-based Lymph2Cx assay has been validated as a reliable surrogate of high-throughput gene expression profiling assays for distinguishing between GCB and ABC DLBCL and provides reliable results from formalin-fixed, paraffin-embedded (FFPE) material. This test has been previously used in clinical trials, but experience from real-world routine application is rare. We routinely applied the Lymph2Cx assay to day-to-day diagnostics on a series of 147 aggressive B-cell lymphoma cases and correlated our results with the immunohistochemical subclassification using the Hans algorithm and fluorescence in situ hybridization findings using break-apart probes for MYC, BCL2, and BCL6. The routine use of the Lymph2Cx assay had a high technical success rate (94.6%) with a low rate of failure due to poor material and/or RNA quality. The Lymph2Cx assay was discordant with the Hans algorithm in 18% (23 of 128 cases). Discordant cases were mainly classified as GCB by the Hans algorithm and as ABC by Lymph2Cx (n = 11, 8.6%). Only 5 cases (3.9%) were classified as non-GCB by the Hans algorithm and as GCB by Lymph2Cx. Additionally, 5.5% of cases (n = 7) were left unclassified by Lymph2Cx, whereas they were defined as GCB (n = 4) or non-GCB (n = 3) by the Hans algorithm. Our data support the routine applicability of the Lymph2Cx assay.

Immunohistochemical subtyping of diffuse large B-cell lymphoma into germinal center B-cell and activated B-cell subtype, along with correlation of the subtypes with extranodal involvement, serum lactate dehydrogenase, and positron emission tomography scan-based response assessment to chemotherapy.

Context: Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma in Indian population and is divided into the prognostically important subtypes, germinal center B-cell (GCB) and activated B-cell-like (ABC), using immunohistochemistry-based algorithm. Aim: The present study aims to evaluate the influence of immunohistochemical derived DLBCL subtype, GCB or ABC on prognostically significant variables - extranodal involvement and serum lactate dehydrogenase (LDH) level at presentation, and response to chemotherapy assessed on pre- and posttreatment fluorodeoxyglucose-positron emission tomography study. Settings and Design: This was a retro-prospective, 2-year observational study at a tertiary health-care center, New Delhi. Subjects and Methods: The study population includes a total 236 cases of DLBCL. According to the Hans algorithm, DLBCL cases were allocated to the GCB and ABC subgroups. Statistical Analysis Used: For comparison of mean values, independent t-test and analysis of variance were used. For this purpose, we used SPSS 20.0 software. P < 0.05 was considered as statistically significant. Results: Ninety-eight patients (41.5%) had GCB immunophenotype and 138 patients (58.5%) were ABC. A significant difference was observed between mean baseline level of LDH between GCB and ABC subtypes (P < 0.05). The proportion of cases with extranodal involvement was comparatively higher in ABC subtype (P < 0.05). Association between response to chemotherapy with DLBCL immunophenotypes was found to be highly significant (P < 0.00). The response rates were much better in GCB subtype. Conclusions: The mean baseline level of LDH is significantly higher in ABC subtype. The proportion of cases with extranodal involvement was comparatively higher in ABC and shows poor response to chemotherapy as compared to GCB. Baseline LDH level was found to be important prognostic marker in the DLBCL.