General Paralysis in Twins

1888 ◽  
Vol 34 (145) ◽  
pp. 65-69 ◽  
Author(s):  
Dr. Clouston ◽  
Dr. Savage.
Keyword(s):  

Several interesting examples of the insanity of twins have been recorded in this Journal. No instance, however, has been published in any journal of insanity as occurring under this condition, in the form of general paralysis. The first case is reported by Dr. Clouston, from whom we have received the following notes; the second case was that of a patient in Bethlem Hospital, under the care of Dr. Savage.

1896 ◽  
Vol 42 (176) ◽  
pp. 233-234

During the early weeks in November there were two cases in the Probate Court before Mr. Justice Barnes of interest to the Association. They were both questions in which the validity of wills was contested on the ground of insanity in the testators. In the first case, Brown and Baker v. Pain, the facts were briefly as follows:—A gentleman who had been employed as clerk in the Courts of Justice, and who for several months before the final breakdown in his mental health had been unfit for even simple copying work. When seen by an expert in June, 1894, he was suffering unmistakably from general paralysis of the insane in an advanced stage, so that he had no knowledge of time or place, and was quite incapable of taking care of himself or of recognising his duties and responsibilities. The real question at issue was whether within a short time (two or three weeks in fact) of that period he might have been able to dispose of his property. The trial lasted five days (see “Times,” November 7th, 8th, 9th, 12th and 13th), and there was the usual amount of conflict as to the capacity of (Mr. Toogood) deceased at or about the end of May, 1894. There was only one medical witness to support the sanity of the deceased shortly before the time at which he made his will, and this witness was not particularly strong as to his mental capacity. On the other hand, a doctor who saw him frequently and Dr. Savage considered it very unlikely that deceased could have made a valid will at the time alleged. In cross-examination the latter witness was asked what he considered to be the points proving capacity in a testator, and he said that he considered the following to be essential:—First, a knowledge of the property to be devised; second, a knowledge of the relatives who might be benefited; third, a just appreciation of the testator's relationship to his friends and relatives; fourth, power of self-control, enough to prevent undue influence; and finally, memory of recent and more distant events. This definition was accepted by the judge and counsel as good and falling in with all legal judgments. Considerable stress in cross-examination was laid upon the periods of remission, or, as they were called, lucid intervals, which may occur in general paralysis of the insane, and Dr. Savage in cross-examination admitted that in general paralysis of the insane it is common to have intervals during which responsibility may exist to the full. It will be remembered that only last year the same question was raised (re Crabtree) as to the validity of a will made by a general paralytic during a remission, and it seems to be established that during lucid intervals testamentary acts may properly be performed. In the end the jury found for the will, which was made within so short a time of the full development of symptoms of general paralysis of the insane. This case once more bears out the common experience that an English jury will very rarely upset a fairly reasonable will on any grounds whatever, and that unless a very distinct insanity can be made evident before the drawing up of the will, the plea of insanity afterwards will be of little value.


2020 ◽  
Vol VII (3) ◽  
pp. 163-165
Author(s):  
V. Obraztsov

Prof. Etienne devotes his article to the analysis of three clinical cases of general paralysis depending on typhus. In the first case, the general paralysis observed by the author came on 3-4 days after he recovered from typhoid fever. It began with the lower extremities, crossed over to the upper limbs, captured the muscles of the trunk, and the patient died with the appearance of asphyxiation for several days. Paralysis developed painlessly. On the part of the rectum and urinary bladder, incontinence is noted. Such cases are usually diagnosed as Landry's disease, that is, a motor pair of an ascending type, ending with lethal bulbar phenomena, without disturbances from the side of sensitivity and without trophic disorders.


Author(s):  
Kosuke Ueda ◽  
Hiroto Washida ◽  
Nakazo Watari

IntroductionHemoglobin crystals in the red blood cells were electronmicroscopically reported by Fawcett in the cat myocardium. In the human, Lessin revealed crystal-containing cells in the periphral blood of hemoglobin C disease patients. We found the hemoglobin crystals and its agglutination in the erythrocytes in the renal cortex of the human renal lithiasis, and these patients had no hematological abnormalities or other diseases out of the renal lithiasis. Hemoglobin crystals in the human erythrocytes were confirmed to be the first case in the kidney.Material and MethodsTen cases of the human renal biopsies were performed on the operations of the seven pyelolithotomies and three ureterolithotomies. The each specimens were primarily fixed in cacodylate buffered 3. 0% glutaraldehyde and post fixed in osmic acid, dehydrated in graded concentrations of ethanol, and then embedded in Epon 812. Ultrathin sections, cut on LKB microtome, were doubly stained with uranyl acetate and lead citrate.


Author(s):  
D.T. Grubb

Diffraction studies in polymeric and other beam sensitive materials may bring to mind the many experiments where diffracted intensity has been used as a measure of the electron dose required to destroy fine structure in the TEM. But this paper is concerned with a range of cases where the diffraction pattern itself contains the important information.In the first case, electron diffraction from paraffins, degraded polyethylene and polyethylene single crystals, all the samples are highly ordered, and their crystallographic structure is well known. The diffraction patterns fade on irradiation and may also change considerably in a-spacing, increasing the unit cell volume on irradiation. The effect is large and continuous far C94H190 paraffin and for PE, while for shorter chains to C 28H58 the change is less, levelling off at high dose, Fig.l. It is also found that the change in a-spacing increases at higher dose rates and at higher irradiation temperatures.


Author(s):  
Ralph Oralor ◽  
Pamela Lloyd ◽  
Satish Kumar ◽  
W. W. Adams

Small angle electron scattering (SAES) has been used to study structural features of up to several thousand angstroms in polymers, as well as in metals. SAES may be done either in (a) long camera mode by switching off the objective lens current or in (b) selected area diffraction mode. In the first case very high camera lengths (up to 7Ø meters on JEOL 1Ø ØCX) and high angular resolution can be obtained, while in the second case smaller camera lengths (approximately up to 3.6 meters on JEOL 1Ø ØCX) and lower angular resolution is obtainable. We conducted our SAES studies on JEOL 1ØØCX which can be switched to either mode with a push button as a standard feature.


2003 ◽  
Vol 8 (5) ◽  
pp. 4-12
Author(s):  
Lorne Direnfeld ◽  
James Talmage ◽  
Christopher Brigham

Abstract This article was prompted by the submission of two challenging cases that exemplify the decision processes involved in using the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). In both cases, the physical examinations were normal with no evidence of illness behavior, but, based on their histories and clinical presentations, the patients reported credible symptoms attributable to specific significant injuries. The dilemma for evaluators was whether to adhere to the AMA Guides, as written, or to attempt to rate impairment in these rare cases. In the first case, the evaluating neurologist used alternative approaches to define impairment based on the presence of thoracic outlet syndrome and upper extremity pain, as if there were a nerve injury. An orthopedic surgeon who evaluated the case did not base impairment on pain and used the upper extremity chapters in the AMA Guides. The impairment ratings determined using either the nervous system or upper extremity chapters of the AMA Guides resulted in almost the same rating (9% vs 8% upper extremity impairment), and either value converted to 5% whole person permanent impairment. In the second case, the neurologist evaluated the individual for neuropathic pain (9% WPI), and the orthopedic surgeon rated the patient as Diagnosis-related estimates Cervical Category II for nonverifiable radicular pain (5% to 8% WPI).


VASA ◽  
2004 ◽  
Vol 33 (4) ◽  
pp. 247-251 ◽  
Author(s):  
Zeller ◽  
Koch ◽  
Frank ◽  
Bürgelin ◽  
Schwarzwälder ◽  
...  

Diagnosis of non-specific aorto-arteritis (NSAA, Takaysu's arteritis) is typically based on clinical and investigational parameters. We report here about two patients with clinically suspected diagnosis of a Takayasu's arteritis already under anti-inflammatory therapy in whom percutaneous transluminal atherectomy of subclavian and axillary artery stenoses was performed to relief the patients from symptoms – intermittent dyspraxia of the arms – and to verify the clinical diagnosis by histology. In the first case aorto-arteritis could be histologically confirmed through the analysis of plaque material including media structures excised from the subclavian and axillary arteries using a new device for atherectomy. The biopsy showed diffuse inflammation and granulomatous lesions with giant cells typically for Takayasu's disease. In the second patient, biopsy showed no acute or chronic inflammatory signs but only atherosclerotic lesions. Percutaneous transluminal atherectomy is therefore not only an interventional but also a diagnostic tool and should be used in every case of interventional therapy of suspected aorto-arteritis to make the clinical diagnosis and as a major consequence the initiation of an aggressive anti-inflammatory medical therapy more reliable.


VASA ◽  
2008 ◽  
Vol 37 (3) ◽  
pp. 289-292 ◽  
Author(s):  
Katsinelos ◽  
Chatzimavroudis ◽  
Katsinelos ◽  
Panagiotopoulou ◽  
Kotakidou ◽  
...  

Gastric antral vascular ectasia (GAVE) is an overt or occult source of gastrointestinal bleeding. Despite several therapeutic approaches have been successfully tested for preventing chronic bleeding, some patients present recurrence of GAVE lesions. To the best of our knowledge, we report the first case, of a 86-year-old woman who presented severe iron-deficiency anemia due to GAVE and showed recurrence of GAVE lesion despite the intensive argon plasma coagulation treatment. We performed endoscopic mucosal resection of bleeding GAVE with resolution of anemia.


Swiss Surgery ◽  
2003 ◽  
Vol 9 (5) ◽  
pp. 227-236 ◽  
Author(s):  
Majno ◽  
Mentha ◽  
Berney ◽  
Bühler ◽  
Giostra ◽  
...  

Living donor liver transplantation is a relatively new procedure in which the right side of the liver is harvested in a healthy donor and transplanted into a recipient. After the first case in 1994, over 3000 cases have been done worldwide. This review summarizes the reasons why the procedure is needed, describes its main technical aspects, highlights the boundaries in which it can be done safely, summarizes the current experience worldwide and describes the main points of the program in our unit. We argue that living-donor transplantation is a viable alternative to a long time on the waiting list for several patients, and it can be performed safely and successfully provided that all precautions are undertaken to minimize the risks in the donor and to increase the chances of a good outcome in the recipients. If these prerequisites are met, and within the framework of a structured multidisciplinary program, we believe that living-donor liver transplantation should be funded by health insurances as a recognized therapeutic option.


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