Genuine Entity Research Articles

Mild Traumatic Brain Injury

This article attempts to align, and in some instances refute, previously held notions about the definition, assessment, and treatment of mild traumatic brain injury (TBI). Recent research and clinical opinions are presented to describe the epidemiologic, pathophysiologic, diagnostic, and rehabilitation issues relative to mild TBI. Contemporary thinking indicates that mild TBI is a genuine neurologic entity and that proper assessment and treatment must appreciate the subtle yet distinctive hallmarks of the disorder. Pharmacologic management, psychological support, vocational analysis, and community-integrated treatment approaches offer considerable promise for those with persistent and catastrophic sequelae of mild TBI.

Clinicopathologic hallmarks of mammary tubular carcinoma

Tubular carcinoma of the human breast is a rather uncommon neoplasm, which is characterized by particular histopathologic features and which seems to be either "scored down" (as grade I carcinoma) or overdiagnosed. Since this special variant of mammary cancer has been shown to respond more favorably to therapy than do common infiltrating carcinomas, its recognition as a genuine entity is important. Nineteen cases were studied and compared with the 110 tubular carcinomas reported in the literature. The basic clinicopathologic and histopathologic characteristics of true tubular carcinoma are discussed.

Malignant Cachexia

Well-known authorities such as Ewing and Willis have thrown doubt on the existence of a constitutional effect of malignant disease other than that due to hæmorrhage, infection, mechanical pressure, &c. On the other hand, Greenstein has taken the opposite view and maintains that a local malignant growth has a general constitutional effect. The clinical picture of malignant cachexia is as clear cut as that, for example, of old age. Malignant cachexia is a recoverable state in certain circumstances when the primary growth is removed; clinical evidence warrants the conclusion that it is a genuine entity and that it is a generalized disease. The laboratory findings have not established that the degree of depression of any one system is the predominant cause of death. Clinically however, the most deadly effects seem to be those produced on the cardiac and alimentary musculature. Experimental evidence would seem to have shown that there is a specific effect, chiefly on one of the cellular enzymes, catalase, predominantly in the liver but also to a lesser extent in the kidney. There is also a marked effect on the blood-forming organs. Greenstein's view that there is depression of the metabolism of the iron porphyrins naturally attracts our attention. Whether this effect is the result of some substance added to the circulation or taken from the circulation is uncertain, but an additional effect seems most probable. Tissue culture may enable us to confirm the existence of the metabolite responsible, and perhaps to identify it. The hitherto untreatable anmmia of malignant cachexia gives us another line of investigation.