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Cumulatively, published accounts and studies of both nonsurgical and surgical amputations available in surgical literature, in the press and other media, and even general literature, and in many languages, are immeasurably extensive. Complete monographs are few, but most early surgical textbooks contain comprehensive chapters on amputation, some with a historical sketch, whilst many monographs and university theses are limited to particular aspects of this subject. Countless lesser communications concentrate on personal experience and case histories, or isolated aspects of the etiology, pathology and indications for or against amputation, and especially on operative techniques, instrumentation, postoperative management, problems of amputation stumps, the fitting and manufacture of prostheses, or the statistics of surgery in relation to operative procedures. Only a few authors mention the possibility of prehistoric limb loss before elective surgical methods developed.28 In particular,...
The instigator of the rather acrimonious debate with Jacques Monod was the molecular biology correspondent'' of the journal Nature, who, at that time, wrote unsigned weekly contributions related to current work in the field. He has since been identified as Walter Gratzer, well known today both as a molecular biologist and as a writer of semipopular works in general science. Gratzer expressed his dismay at the faddishness of the allosteric phenomenon, using the enzyme aspartate transcarbamylase as an example. He noted Monod's enthusiastic discovery of the use of guanidine as an agent for denaturation (and polypeptide disruption) and as a medium for measurement of subunit molecular weights. Gratzer pointed out with some sarcasm (perhaps even jokingly) that it should really be called a rediscovery'' citing the work from my laboratory and others in America as a precedent.
A travel guide to places in Europe that were associated with the lives of great scientists of the past or that were sites of special scientific interest in a more general way - institutions, archaeological or geological features, etc. We had always enjoyed traveling, especially in Europe, and had been annoyed by the one-sidedness of most travel guides, which tend to extol the virtues of liberating revolutionaries, battle heroes, architects, painters, and politicians, but almost invariably ignore scientists and scientific discoveries that merit equal prominence in popular culture. We wanted to remedy this by providing appropriate raw material for writers of guide books to enable them to appreciate the rich heritage of science and hopefully to transmit some of it to their readers.
The passing of excess urine or polyuria, associated with great thirst, is a condition noted by Aretaeus in the 2nd century A.D. but, according to Adams, neither he or any other ancient writer appears to have known of an association with sweetness of the urine40 this is first attributed to Willis, who wrote
These descriptive differences have been laboured here, as early writers considered gangrene and sphacelus distinct conditions requiring different management, that of sphacelus having no remedy save speedy separation of dead tissues, assisted either by the surgeon or by nature. For the past two centuries this distinction has not been preserved, and sphacelus has lapsed from the medical literature. It may be clearer to differentiate a pregangrenous state when ischaemia caused by arterial circulatory failure is evident but reversible, followed by a gangrenous state when tissue death, however small, is clinically visible and irreversible (Fig. 2.2a).
Immediate complications of haemorrhage, infection, gangrene, septicaemia and death have been noted in earlier chapters. Older writers also comment on postoperative spasms of the stump which, in 1822, S. Cooper stated can cause painful agony, with contractions of stump muscles precipitating bony protrusion and, also, generating more widespread muscle spasms, leading occasionally to death19 he does not mention tetanic spasms which could be mortal. Velpeau confirmed local spasms in 1832, even present before the stump was dressed, usually responding to binding stumps firmly to the mattress and by patients taking opium.20 Conceivably, some spasms were caused by accidental inclusion of nerves in vascular ligatures
Most of the information that Americans receive about science and technology comes from television news programs and newspapers (Nelkin 1987). The news media has become increasingly interested in reporting the results of research as they are published in journals or presented at scientific conferences. Science and health writers scour the hundreds of studies published each week. Their selection of which published research will be played in a lead story shapes the public image of the critical health issues of the day. Many health professionals first learn about the results of an important study by reading it in the morning paper or hearing it on the six o'clock news.
In ancient times changes in the skin were taken to indicate that the whole body was diseased and although arguments continue about what the Old Testament writers understood by leprous , there was clearly an appreciation of the connection between the skin and systemic illness. Clinical signs in the skin may give valuable diagnostic clues to underlying disease. The cutaneous signs of systemic disease is a very large subject and what follows is only an outline of the more common skin changes that may be associated with systemic illness.
Early surgical writers such as Pare and Wiseman mention arm amputations without indicating sites of election, although Fabry (Hildanus) noted a patient with a gangrenous arm after venesection, presumably at the elbow followed by infection, whom he amputated at the level of the axilla.74 It is only in the 18th century that levels become more specific.
An avalanche of advice literature, especially texts dealing with health and diet, was a major product of the print revolution. Popular texts in the vernacular told people what foods, drugs, and spices were ''good'' or ''bad'' for their health, explaining proper food choices in terms of humoral and medical theories. Advice on hygiene still discussed the Galenic rules of health or regimen in terms of the six non-naturals food and drink, air or the environment, exercise and rest, sleep and waking, evacuation and repletion, and the passions of the soul or the emotions. Similar formats were adopted by texts that gave advice to wealthy readers about sex, clothing, cosmetics, health, family life, managing pregnancy and childbirth, wet-nursing, child rearing, and so forth. Medical writers had to find ways of adapting medical theories to New World plants such as tomatoes, potatoes, and tobacco that were being used as foods and drugs. Written advice could get very detailed without causing...
Should the population be regarded - or the ecosystem as a whole - as a unit of selection Populations change (diverge) by natural selection among individuals species change because their populations change ecosystems change because species co-evolve. On the other hand, some writers have argued that genes are the units of selection the environment of a gene is other genes. We would not go along with this last point of view, but it has a respectable following. The fundamental concepts here, selection and environment , are difficult to pin down. More than one meaning can be ascribed to each.
Buxton called a series of meetings with friends and associates at his house, and they decided to gather powerful signatories for a letter to Lord Cromer, then Governor-General of the Sudan. This was duly written, and signed by a panoply of aristocratic or political figures, including the Duke and Duchess of Bedford, Sir Edward Grey, Lord Avebury, the Marquis of Hamilton, and the Earl of Rosebery, Sydney Buxton (Edward North Buxton's brother), and Sir Henry Seton-Karr businessmen such as brewery owner Samuel H Whitbread scientists and naturalists including Oldfield Thomas, Ray Lankester, P L Sclater and Richard Lydekker. There were also colonial administrators such as Sir Harry Johnston, and famous hunters and writers about Africa, notably Federick Courtney Selous.
Judging by recent reports on ADHD children it appears that Barkley's theory is slowly but surely becoming the preferred theory for most writers. He is concerned only with the HY-impulsive type and mainly with the explanation of IMP. Barkley (22) defines response or behavioral inhibition as consisting of three interrelated components These early findings seem to us to support many of the conjectures of Barkley, including those mentioned by the prominent writers he references (232-234). Pavlov and his associates studied individual animals intensively over long periods of time. His null or no hypothesis was not a statistic but an experimental manipulation to prove a point. It is a shame that the books that do mention his work do so in such a cavalier and superficial manner.
With the documentation of sensory map abnormalities in the animal model, researchers predict that some sensory processing measures, which are sensitive to the types of perturbations seen in focal hand dystonia, would be abnormal as well. One study (Byl et al. 1996a) found abnormalities in graphesthesia and manual form perception, two percepts that require integration of somatosensory input across the skin. Two studies have found abnormally poor spatial acuity on the fingertips (Bara-Jimenez et al. 2000 Sanger et al. 2001) as assessed with a grating orientation task (Johnson and Phillips 1981). One study also found abnormal spatial localization (Bara-Jimenez et al. 2000), which is consistent with poor performance on graphesthesia and manual form perception. Temporal discrimination was also abnormal in patients with writer's cramp (Sanger et al. 2001), and patients with generalized dystonia (Tinazzi et al. 1999). In that test, patients are asked to detect the number of pulses, one or...
Before anaesthesia, it was never easy for either surgeons to recommend and, more especially, it was extremely difficult for patients to accept amputation. As Gross observed,43 many limbs were removed unnecessarily and many retained that should have been promptly removed. And even today, there are situations when experienced surgeons find the choice of action an equivocal dilemma. In the past, bad advice could certainly prove disastrous. For example, Usmah, a 12th-century Arabic writer, reported that a crusading knight was receiving treatment for a leg ulcer from a Lebanese physician with some success
Although it is not always easy to maintain good legibility in the heat of the moment, every effort should be made to ensure that entries in the notes, and particularly signatures, can be read. While most doctors can read their own handwriting, this is not always true 20 years later, and it should be borne in mind that the interpretation will often be made by someone other than the writer. Each signature in the notes should be followed by the author's name in capital letters.
Dystonia have many subtypes, and is classified as focal, segmental and generalized. As for focal dystonia, spasmodic torticollis (cervical dystonia) and writer's cramp are most common. Cervical dystonia is mainly treated effectively with selective peripheral denervation, and task specific focal dystonia of the hand (writer's cramp) is effectively alleviated by stereotactic ventro-oral thalamotomy. Generalized dystonia is dramatically improved with deep brain stimulation of the globus pallidus interna. Because the majority of dystonia is medically refractory and surgical treatment results in marked improvement, the authors strongly believe that dystonia should be regarded as a definite neurosurgical indication. Based on personal experience of nearly 200 cases of dystonia surgery, the authors describe a multimodal approach to various types of dystonias. Also we discuss possible relation between dystonias and psychiatric conditions, and future new indication of dystonia surgery. Keywords...
Clinically between PKD and PED with regard to triggering factors. For example, the dyskinetic attacks in patients with the so-called ICCA syndrome mentioned earlier could be triggered both by sudden movements and by ongoing exercise. Interestingly, in this regard a recessive family with rolandic epilepsy, episodes of exercise-induced dystonia, and writer's cramp (RE-PED-WC syndrome) has been linked to chromosome 16p 12-11.2 31 in the same region as the families with the ICCA syndrome 12,13 , again suggesting a possible overlap between these disorders.
Did harm to the institute.' Please note that the notice does not mention the name of Mengele Tuberculosis and eyes are interchanged. The writer, Havemann, was a physico-chemist. As a communist he had been incarcerated by the Nazis until the end of the war and afterwards was made president of the KWG by the Russians. This had not been accepted by the rest of the KWG in the western zones. Havemann later became one of the first outspoken intellectual dissidents of the German Democratic Republic. He lost his professorship and died in isolation.
Traumatic amputations of the fingers and toes were probable early examples of complete tran-section, due to the use of stone hand axes and other tools, crushing by rocks or building stone and accidents in mines a shoeless society was particularly vulnerable to injuries of the feet. Eventually, metal tools and, ultimately, industrialisation with mechanically motivated machinery became major sources of hand injuries. Most accident services are familiar with wood machinists who sustain circular saw amputations indeed the writer recalls treating a carpenter who had a series of saw injuries over many years and had to retire having, on this occasion, lost his last remaining finger, although he still retained his thumbs this occurred before reattachment of digits was practised.
In 1579, on a stage set up in the market-place at Westminster. John Stubbs, a religious writer, and William Page, his publisher, 'had their right hands cut off by the blow of a butcher's knife with a mallet struck through their wrists' for having produced a pamphlet criticising
Sion programmes confirm such disputes are part and parcel of civilisation, which is not to say the participants concerned are aiming to achieve amputations, for other forms of maiming and mayhem are much easier to attain. Manually inflicted injuries with stones and clubs were unlikely to sever limbs, although doubtless crushed fingers complicated by infection and gangrene sometimes separated from living tissues. The appearance of stone axes and other cutting tools increased the possibility of limb severance, although the writer considers clean section through the tibia, humerus and femur would have been difficult if not impossible to attain with a single blow. Apart from fingers and hands severed during sword fights, major limb amputations must have been rare before the Iron Age a heavy bronze axe might amputate an arm but an iron or steel axe would have proved more efficient. At the Battle of Hastings as depicted in the Bayeux Tapestry, scrutiny shows many axe-men and several...
The Scientific Revolution is generally thought of as the great transformation of the physical sciences that occurred during the sixteenth and seventeenth centuries, and is primarily associated with Nicolaus Copernicus (1472-1543), Johannes Kepler (1571-1630), Galileo Galilei (1564-1642), and Isaac Newton (1642-1727). Some scholars have tried to explore the problem of why the Scientific Revolution occurred in Europe in the seventeenth century, rather than in China or Islamic areas, which reached a sophisticated level in science and technology centuries earlier. Other scholars have dealt with the questions by arguing that there was no such thing as a European Scientific Revolution. After all, during the alleged Scientific Revolution, interest in astrology, alchemy, magic, religion, and theory persisted. Yet other scholars see the Scientific Revolution are a valid metaphor for the transition from a pre-modern to a modern worldview, in which science is at the very core of life and...
Mary Putnam Jacobi (1842-1906), an eminent physician and medical writer, explicitly asserted that women were diagnosed as perpetual invalids because doctors saw them as lucrative patients. Her book The Question of Rest for Women During Menstruation, which was written to answer the question ''Do women require mental and bodily rest during menstruation, and to what extent ,'' won the Boylston Prize from Harvard University in 1876. Jacobi's work demonstrated that education and professional work did not damage women's health. Indeed, educated women were healthier than any other group of women. Certainly, many women were not as healthy as they could be, but the true remedy for them was more education, not less. Sickly women were most likely the victims of alcoholic fathers, husbands with venereal diseases, and ''bad social arrangements,'' but hysteria and other debilitating ''nervous diseases'' supported doctors like Clarke quite well, because they were ''never fatal, impossible to cure,...
Many of the early Greek philosophers and medical writers have been largely forgotten, but the name Hippocrates (ca. 460-360 b.c.e.) has become synonymous with the phase ''Father of Medicine.'' The establishment of medicine as an art, a science, and a profession of great value and dignity has been associated with the life and work of Hippocrates. Yet surprisingly little is known about his life. Indeed, some historians insist that Hippocrates was neither the author of the Hippocratic collection nor even a real person. For the sake of simplicity and tradition, we shall use the name Hippocrates as the exemplar of the ideal physician of antiquity and for any of the authors of the medical texts attributed to Hippocrates. Presumably, these texts were written by physicians who practiced medicine in accordance with the principles known to us as Hippocratic medicine. According to ancient biographers, Hippocrates was born on the island of Cos, lived a long, exemplary life, and died in Larissa...
In contrast to the liberal elementary school, the Herzlyyia Gymnasium I attended was formal and demanding. Teachers had to be addressed by the students standing up, in the third person, and discipline was strictly enforced. It took me some time to adapt to the change in atmosphere. However, our teachers were among the best intellectuals, writers, and scientists who had immigrated to the country, often with PhD degrees. In particular, I enjoyed the lessons in biology, botany, physics, and soil chemistry.
This type of injury has since been associated with fast-moving belts of powered machinery, the belt drawing in the arm until blocked by the trunk and, it is assumed, reflex resistance by the victim to produce separation of the shoulder girdle from the trunk with tearing of attached soft tissues, predominately muscles, vessels and nerves. As Cheselden noted the arteries are stretched and bleed very little, presumably because they shut down immediately after tearing due to retraction of the elastic inner and middle coats of the vessels within a sheath of the tougher outer fibrous layer. The writer has seen a very similar shoulder avulsion involving a coal miner whose arm was caught in a moving belt despite this massive injury he was able to walk some distance to the cage bottom before evacuation and, on reception in the acci-
What is most surprising about Hansen's disease is the fact that it is only slightly contagious. Many people having extended and intimate contact with lepers, such as spouses, nurses, and doctors, do not contract the disease, whereas others with little contact become infected. Where leprosy remains endemic, almost all people have been exposed to the infectious agent, but only a small percent actually contract the disease. Those who do seem to have a deficiency in their immune system that makes them unusually susceptible M. leprae. Evidence of the limited degree of contagiousness of leprosy today does not, of course, prove that the disease was not more contagious in the past. Nevertheless, leprosy could not have been as contagious as medieval writers assumed. Religious and medical authorities argued that leprosy could be spread
Revolution eventually eclipsed the ancient anodynes. Joseph Priestly (1733-1804), British theologian, educator, writer, and political theorist, is best known as the discoverer of oxygen, but as Sir Humphry Davy (1778-1829) said of this indefatigable chemist, ''no single person ever discovered so many new and curious substances.'' Most curious of all was the gas known as nitrous oxide, or laughing gas. As he was in the habit of testing the effect of new gases on himself, Priestley might have discovered the anesthetic properties of laughing gas if his research had not been interrupted by the political and religious conflicts that forced him to emigrate to America in 1794.
Upon a casual reading of the criteria for the various personality disorders, one may see many descriptions that may seem applicable to oneself or others at times. Symptoms of various personality disorders include, as examples, emotional lability, feelings of emptiness, bearing grudges, lacking close friends, suspiciousness, impulsivity, suggestibility, feeling envious, concern with criticism or rejection, difficulty in making everyday decisions, and perfectionism. In fact, many writers have criticized the DSM series' Personality Disorders for pathologizing anyone who simply may be
The Roman Empire was a complex and vigorous combination of Greek and Roman cultural elements, forged through centuries of war. Originally a republic of yeoman farmers, rather than merchants and adventurers like the Greeks, Roman citizens retained a preference for the practical over the abstract and a tendency to idealize the pastoral life even as they constructed cities unprecedented in size and complexity. They excelled in the arts of warfare and administration, as well as architecture, engineering, public health, and hygiene. Roman writers boasted that their ancestors had lived without physicians, though not without medicine, being well endowed with folk remedies, healing deities, and diviners. Presumably, the remarkable sanitary engineering achievements that are associated with Republican and Imperial Rome played an important role in maintaining public health. De medicina provides a valuable survey of the medical and surgical practices of first-century Rome. However, during the...
Greatly influenced by a number of writers the pioneering work of Strauss and Lehtinen (27), who enumerated the characteristics of children with known brain damage the study of Bradley (28) showing that Benzedrine reduced hyperactivity the published work on perinatal risk factors (e.g., bleeding in pregnancy, low birth weight) in causing behavior and learning problems and a variety of other papers suggesting that neurological impairment results in behavioral and emotional symptomatology (6,29-34). The MBD term as used by Clements and Peters designated children who were HY, LD, or both. It included one or more of the following signs specific learning deficits, perceptual-motor deficits, general coordination deficits, hyperkinesis (extreme overactivity), impulsivity, emotional lability, short attention span and or distractibility, equivocal neurological signs, and borderline abnormal or abnormal electroencephalogram (EEG). Clements and Peters gave a description of MBD that could be used...
Western scholars long maintained that the major contribution of Arabian medicine was the preservation of ancient Greek wisdom and that medieval Arabic writers produced nothing original. Because the Arabic manuscripts thought worthy of translation were those that most closely followed the Greek originals (all others being dismissed as corruptions), the original premise lack of originality was confirmed. The strange story of Ibn an-Nafis (1210-1280 Ala ad-Din Abu al-'Ala 'Ali ibn Abi al-Haram al-Qurayshi-ad-Dimashqi Ibn an-Nafis) and the pulmonary circulation demonstrates the unsoundness of previous assumptions about the Arabic literature. The writings of Ibn an-Nafis were essentially ignored until 1924 when Dr. Muhyi ad-Din at-Tatawi, an Egyptian physician, presented his doctoral thesis to the Medical Faculty of Freiburg, Germany. If a copy of Tatawi's thesis had not come to the attention of the historian Max Meyerhof, Ibn an-Nafis' discovery of the pulmonary circulation might have...
The medical texts available for use by the time medical faculties were established included many translations from Greek and Arabic manuscripts, as well as new Latin collections and commentaries. However, before the fifteenth century, students and professors lacked access to many of the surviving works of Hippocrates, Galen, and other ancient writers. Some of Galen's most important texts, including On Anatomical Procedures, were not translated into Latin until the sixteenth century. Some manuscripts were extremely rare and many of the Latin texts attributed to Hippocrates and Galen were spurious.
I'd been working with Clive Horwood of Praxis for some time in regard to a Springer-Praxis book I'd co-authored with British space writer David Shayler (NASA's Scientist-Astronauts) , and I felt this book might work well as part of their superb space science catalogue. To our delight the proposal was accepted, at which time we formulated what each of us would write for the book. Skip ahead some 45 years. An anniversary of Laika's flight renewed my interest in the subject and motivated me to write a book in 2003 about all of the dogs used in the Soviet space program. Although, I had worked as a writer all of my life, Space Dogs Pioneers of Space Travel was my first venture into writing space history. Surprise gifts showed up from around the world, from writers, space enthusiasts, auction houses and museum directors, as if the world had kept these secrets in its collective attic all these years, and now that someone was finally asking questions, they could be given a home.
Dystonia, defined as a sustained, involuntary contraction of muscles producing an abnormal posture, may be generalized (legs plus other parts of the body), segmental (multi-focal), focal, or unilateral. The adult onset torsion dystonias are usually sporadic and proximal in distribution (e.g., torticollis). Distal dystonia, often seen in children and adolescents, is commonly inherited and may progress to generalized dystonia. Cranial dystonia (e.g., Meige syndrome, blepharospasm, oromandibular dystonia), cervical dystonia (e.g., various combinations of rotational torticollis, anterocollis, and retrocollis), and focal task-specific dysto-nias (e.g., writer's cramp) represent useful terms for categorizing the location of these abnormal involuntary movements. Unilateral dystonia (i.e., hemidystonia) is usually associated with a structural lesion in the contralateral striatum, such as an infarction, porencephalic cyst, arte-riovenous malformation, or posttraumatic encephalomalacia (Stacy...
Another way of describing what follows in this book is that it is, in the eyes of the writer, made up of all the interesting bits of psychology. It is intended for anyone who either wishes or is forced to study psychology for a year as part of some other qualification they are pursuing. They may never read any psychology again. If so, I would like to give them a large set of facts, ideas and suggestions that not only make more than common sense but also that they can use in their own lives. As a by-product, it may well also help them to pass whatever examination they have to take. If the aim of the book is successful, then anyone who has read it will, in fact, go on to read more psychology, for no reason other than interest. They will, however, have to choose carefully.
For preparing and reviewing submissions, the regulatory liaison should avail himself of the services of one or both of the physicians, the statistician, a medical writer, and the clinical monitors. He or she needn't be a gifted writer but should be able to direct the efforts of those who are. And, the regulatory liaison needs to be a careful reader.
Your implementation team will consist of a pharmacologist and or manufacturing specialist who will be responsible for providing the drugs and or devices needed for the trials, clinical research monitors who will train, deliver, and monitor the ongoing process, technical writers to prepare the detailed procedures manuals for use by the investigators, the lead software developer who will be responsible for developing the data entry screens as described in Chapter 10, and the database manager who will be responsible for maintaining the integrity of the collected data as described in Chapter 11. The qualifications for the latter two individuals are outlined in the next section.
A problem that Barkley (184) pointed out in discussing the limitations of DSM-IV was that of diagnosing ADD ADHD reliably in the preschool years. However, Palfrey et al. (196) had earlier evaluated children at eight checkpoints between birth and age four, and the writers report that 13 of the children met criteria for possible ADD ADHD at one or more checkpoints. However, only 5 of the group evidenced definite symptoms that persisted into kindergarten. The peak age for the identification of symptoms was 3.5 yr. It is obviously dangerous to make a diagnosis of ADD ADHD in the preschool years, because many young children demonstrate behaviors associated with this condition, which is in fact normal for their age. We simply do not have reliable information on the prevalence of ADD ADHD in preschool children.
Love itself is a huge and fascinating topic about which writers of fiction and poetry have probably done rather better than psychologists. Before talking a little about the attachments that make up romantic love, it is important to say that this is only one type of love. There are others. A psychologist called Richard Sternberg (1986) provides a very full breakdown of the various types of love relationship.
27 Group selection theory , advanced by Trivers in 1971, has always been controversial and some writers, not least Richard Dawkins, are strongly antipathetic to it. Dawkins says that everything attributed to group selection can be accounted for by kin selection (behaving altruistically towards close relatives, which share a large percentage of your genome) kin selection theory was pioneered by Hamilton in 1964. Nevertheless some recent ecological evidence, surveyed for example by Sober and Wilson in 1998, is difficult to explain without recourse to group selection.
Our news operation has been directed by Gabrielle Strobel since 2001. It has become one of the most important ways in which Alzforum delivers value, by providing reporting and analysis of news of broad relevance to AD research composed by journalists with extensive knowledge of the field. Our writers aim to place new findings in the context of other research. With their detailed conference coverage, they have mastered the art of informing the field of new developments many months ahead of formal publication to accelerate the spread of new ideas, without interfering with formal publication. They also scout for discoveries and methods from other fields that could be useful to AD research, conduct interviews with thought leaders, and prepare the background texts for discussion forums.
Our examinations also have the potential to elevate the general level of practice. As new developments come to light that can benefit patients, we can ensure that they are incorporated into training programs, including their evaluative activities. By changing the content of examinations, in other words, we can change what medical students and residents are attempting to learn, and thereby enhance the general level of knowledge and skill in the medical community. This is not to suggest that examination writers bear primary responsibility for keeping the profession moving forward. It is inevitable that the content of examinations will lag behind the latest scientific and clinical developments. However, the content of our examinations need not and should not remain the same year after year, decade after decade, or we will exert a retarding influence on medicine that redounds to no one's benefit.
Just as Thomas Sydenham is honored for following Hippocrates in his emphasis on patient care and epidemiological observations, Hermann Boerhaave (1668-1738) is remembered for his role in revitalizing the teaching of clinical medicine. Teacher, writer, and chemist, Boerhaave was probably the most influential physician of the eighteenth century. His contemporaries thought of him as the ''Newton of Medicine.'' Speaking of his own sources of inspiration, Boerhaave emphasized the work of Hippocrates, Francis Bacon, and Thomas Sydenham. It was said that, in deference to the ''English Hippocrates,'' Boerhaave tipped his hat every time Sydenham's name was mentioned. As a student, Boerhaave immersed himself in botany, chemistry, philosophy, and languages. Although, like Sydenham, he suffered the torments of gout, Boerhaave possessed boundless energy as well as erudition, as demonstrated by his simultaneous commitment to professorships in botany, chemistry, medical theory, and clinical medicine...
Lu. 1995. Reciprocal inhibition in writer's cramp. Movement Disorders 10 556-561. Marsden, C.D., and M.P. Sheehy. 1990. Writer's cramp. Trends Neurosci 13 148-153. Sanger, T., D. Tarsy, and A. Pascual-Leone. 2001. Abnormalities of spatial and temporal sensory discrimination in writer's cramp. Mov Disord 16 94-99. Sheehy, M.P., and C.D. Marsden. 1982. Writer's cramp a focal dystonia. Brain 105 461-480.
3-bp deletion (GAG) in the DYT1 (TOR1A) gene that encodes the protein, torsinA (1). Symptoms of this disorder typically present before the age of twenty-one with involuntary sustained muscle contractions that cause posturing of a foot, leg, or arm. The contractions frequently, but not invariably, generalize to other body regions. No other neurological abnormalities are usually present, except for postural arm tremor. Disease severity can vary considerably within the same family. Isolated writer's cramp may be the only sign of dystonia in one family member, whereas another relative may exhibit multifocal or generalized dystonia (2). The lifespan of affected individuals is not shortened and no evidence exists of other medical problems that can be attributed to the DYT1 mutation. Rarely does onset of symptoms occur after the age of twenty-eight, suggesting a window of susceptibility during postnatal development.
In the modern era these dichotomies are still visible, if somewhat obscured by theoretical nuance. Thus, the traditional (if perhaps somewhat tacit) view that hypnosis involves a special or altered state of consciousness is opposed by a variety of social -psychological or cognitive - behavioral views which assert that hypnotic behavior is a result of processes that are in every sense ordinary. However, there is considerable heterogeneity of viewpoint within each camp, which is sometimes ignored by the other side (a common feature of intergroup relations, according to social psychologists). Among those who are sometimes labeled as state theorists (including the present writer) are cognitive psychologists who think that hypnosis involves dissociative processes, psychoanalysts who invoke adaptive regression in the service of the ego, and neuroscientists who emphasize the inhibition of cortical structures. Among the critics of the state view are some who claim that hypnotic effects can be...
They include limb dystonia (from writer's cramp to a dystonic posture of the arm or foot), blepharospasm (and or eyelid apraxia), orofacial dystonia, stridor, axial dystonia, and cervical dystonia. Axial dystonia is sometimes difficult to differentiate from rigidity, especially in the neck. In cervical dystonia, torticollis, retrocollis, or laterocollis are easy to define but antecollis can range from severe bent neck (considered to be a good clue for MSA) to abnormal neck flexion in such cases, cervical dystonia can be found in up to 25 of MSA patients (17) and in most PSP patients (18).
Of these persons, my aunt Vivi Tackholm is probably the most well-known. After having received a BSc degree with botany as main subject, she became a journalist and a writer of children's books. Then she married Gunnar Tackholm, a botanist who became the first head of the Department of Botany at Cairo University. Gunnar and Vivi started the herbarium collection at the university but Gunnar died after a few years. Vivi formally took over the chair when she had received a PhD h.c. for her work on the Egyptian flora. She became a legend in Cairo where she stayed for about 50 years. Vivi lived in Sweden during World War II and in the summers
Szepetowski and colleagues linked four French families with what was described as the ICCA syndrome (infantile convulsions and paroxysmal choreoathetosis) to the peri-centromeric region of chromosome 16 12 . Linkage to the same locus was further confirmed in a Chinese family said to have a similar disorder 13 . Although description of the paroxysmal dyskinetic episodes in these reports was rather limited, they did seem similar to PKD. Not surprisingly, eight Japanese families 14 and an African-American kindred 15 , both with typical PKC, were also linked to the pericentromeric region of chromosome 16. In these Japanese families there was an increased prevalence of afebrile infantile convulsions therefore, it was suggested that one gene may be responsible for both PKC and ICCA 14 . However, the PKC interval identified in the African-American family in which individuals had PKC alone (and no infantile seizures) overlaps by 3.4 cM with the ICC A region and by 9.8 cM with the PKC region...
In contrast to the authoritarian theory X leader, the theory Y leader attempts to create work conditions that match the needs and aspirations of colleagues and learners. Where can each of us make a contribution for which we could be recognized One of us might have strong information technology skills that could be put to work in developing and implementing new educational technologies. Another might be a good writer, and have a lot to offer in developing new educational materials. Still another might be a gifted classroom teacher, and perform best when working with learners in a face-to-face setting. A paramount objective is to involve colleagues and learners in decisions about how their work is targeted, organized, and evaluated, and to frame such decisions in terms of the larger strategy of the educational program.
The writer has been unable to find a surgical saw for measurement older than a decorative saw, now in the Mus e d'Histoire de la M dicine, Paris, identical with an illustration in Woodall's Surgions Mate of 1617 (see Fig. 6.7) it is a massive 67 cm long, weighs 1.85 kg and has the mark of Hobbs of London. Another bow saw of similar style, considered to be of the same period, was estimated to be 62 cm in length.56 Selected bow or frame saws from the 18 th to 20 th centuries measured by the writer indicate that saws of the Woodall era were the largest made and thereafter they diminished gradually in length (see Fig. 6.6). Dionis commented on saws in 1708
Everyone has had some experience with sadness and loss and can empathize with persons caught in the grip of severe depression. Manic-depressive illness is more mysterious. During the up or manic phase, patients may go with virtually no sleep for days on end. Gripped with what seems like euphoria, they spend hours planning and trying to carry out absurdly grandiose or just plain foolish tasks. One famous autobiographical description of mania comes from the writer, Clifford Beers. While at his most manic, he felt an irresistible compulsion to write letters. Regular stationary was much too confining. Given huge rolls of paper, he would write letters that stretched the length of corridors. One measured a full 100 feet. At times his output was measured at 1800 words an hour for hours on end. This bizarre case report resonates with an experience I had as a medical student. I became involved in the care of a man in a manic phase who had spent 48 consecutive hours just prior to his admission...
Remarkably, in his classic 1865 book From the Earth to the Moon, French sciencefiction writer Jules Verne told of a lunar trip successfully undertaken by three men. It was a journey that would have many striking similarities to the first lunar landing by human beings more than a century later. He may rightfully be regarded as a true doyen of science fiction, but not even a writer as wonderfully imaginative and prophetic as Verne could have conjured up the rich and dramatic history that involved animals and their part in the exploration of space. The unfolding of that great adventure awaited only the appearance of vehicles capable of broaching our atmosphere and the dark, mysterious envelope of space beyond.
One of the founding members of the Rocket Society was the prolific science writer and space advocate Willy Ley, later recognised for his gifted ability to accurately frame complex technical material in a form easily understood by the lay reader. He once wrote that the Rocket Society had to make considerable efforts to try and raise funds to convert Professor Oberth's theoretical work into practical reality. It succeeded to some extent and built and fired quite a number of successful liquid-propellant rockets but it must be borne in mind that in those days, from 1930 to 1932, a rocket was considered 'successful' if it worked at all.''
Yet Leo failed the first test of the semester, an essay exam requiring paragraphs to explain aspects of the Civil War that had been covered in the textbook and discussed in class. The teacher was annoyed by his overly terse answers and the lack of elaboration to support his responses. He felt that Leo knew the answers better than anyone else in class. He assumed that Leo had not taken the test seriously. Immediately after class the teacher met with Leo and required him to respond orally to each of the questions on the test. Leo's answers were all top-notch. When the teacher asked Leo why he had written such a poor test paper when he knew all the answers so well, Leo answered, That happens to me all the time. I can know about something and can talk about it with no problem, but I just can't get the ideas written out on the page. All the teachers tell me that my answers are way too short and that I don't elaborate enough. I'm just a really poor writer.
As aerospace writer Lloyd Mallan once noted of prevailing thoughts on such research, specifically mentioning the year 1949, it was a subject reserved for the lunatic fringe of science and the lurid fiction fan.'' He added, however, that many eminent specialists in aviation medicine, particularly those from Germany, England and the United States, had been giving the subject serious thought. Pioneering experiments in aviation medicine had stimulated an awareness of the practicality of exploring the reactions of man's body to the conditions of space'' 4 .
The problems with Picture Arrangement concern the important role that content must play for each item, which introduces variables regarding cultural background, urban versus rural upbringing, sex differences, interests, and so forth. Yet this limitation is also the subtest's greatest asset, because it is the unique content of each item that gives the task its clinical power. Although Wechsler (1958) did not believe in social intelligence (considering it merely the application of general intelligence to social situations), he conceded that comprehension of the Picture Arrangement items more nearly corresponds to what other writers have referred to as 'social intelligence' (p. 75). When individuals perform well on Picture Arrangement, despite poor performance on other tasks, they seldom turn out to be mental defectives (p. 76). Furthermore, Wechsler stressed the clinical information obtainable from listening to the subject explain the story behind his or her arrangement, whether the...
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