THE R?LE OF THE THEBESIAN VESSELS IN THE CIRCULATION OF THE HEART

In summary, evidence has been presented to show a direct connection other than through the capillaries between the coronary arteries and the chambers of the heart. This connection was shown by perfusion, injections and serial sections to be through the Thebesian veins. Communications between the larger coronary veins and the Thebesian veins were also demonstrated by the same methods. Serial sections through Thebesian veins have shown capillaries draining directly into them. Under certain conditions it has been shown that as much as 90 per cent of the arterial flow may escape via the Thebesian vessels. Lastly, in the event of gradual closure of the orifices of the coronary arteries, the Thebesian vessels can supply the heart muscle with sufficient blood to enable it to maintain an efficient circulation.     

THE PRACTICE OF GOOD LEADERSHIP WITHIN THE MEDICAL PROFESSION

My university studies and postgraduate training equipped me to be a competent doctor and medical specialist,but in 1976 when I was 30 years old,I was invited to come to Melbourne to establish a Neonatal Intensive Care Unit in an university teaching hospital and to be its Director.I had never taken any leadership or management course to equip me to be a leader.Now over 30 years later,on the eve of my retirement from medicine,I look back to reflect on what kind of leader I was over the course of my medical career.What wisdom did I gain over the past 30 years on becoming a good leader,based on learning from the mistakes I had made in exercising the leadership roles I was given within the hospital and university,as well as in the national and international professional arenas? This essay begins with a general principle of good leadership followed by an examination of aspects of pride,power and submission,which if misused or abused,constitute a trilogy of harmful influences on the character of leaders and their wise exercise of good leadership.     

THE R?LE OF THE RETICULO-ENDOTHELIAL SYSTEM IN IMMUNITY : I. THE R?LE OF THE RETICULO-ENDOTHELIAL SYSTEM IN THE PRODUCTION OF DIPHTHERIA ANTITOXIN.

1. Following massive doses of India ink injected intravenously into guinea pigs before a subcutaneous injection of diphtheria toxin-antitoxin mixture, no antitoxin was found in the blood serum for 3 weeks, as indicated by intracutaneous tests, whereas an appreciable amount could be detected in non-blocked, immunized control animals. 2. During the 4th week following immunization, the titer of the serum of blocked animals equaled that of non-blocked controls within the limits of the intracutaneous test dose. 3. The smaller doses of India ink used in these experiments, given before immunization, had no stimulating effect on the production of diphtheria antitoxin but, on the contrary, also inhibited the appearance of this antibody, although to a less extent.     

THE EFFECT OF EXERCISE AND TIME ON THE HEIGHT AND WIDTH OF THE MEDIAL LONGITUDINAL ARCH FOLLOWING THE MODIFIED REVERSE‐6 AND THE MODIFIED AUGMENTED LOW‐DYE TAPING PROCEDURES

Purpose/Background:

No evidence exits regarding the magnitude of the change in foot posture following the “modified reverse‐6” (MR6) taping procedure, either alone or in combination with the “low‐dye” (LD) taping technique. The purpose of this study was to investigate the change in the height and width of the midfoot after application of the MR6 and the MR6 plus the LD (MR6+LD) taping technique and determine how long those changes last.

Methods:

Eleven individuals (2 female and 9 male) were recruited for this study and were tested under each of two experimental conditions, the MR6 and the MR6+LD taping technique. The order of testing for the two conditions was randomly determined. For each condition, the height and width of the midfoot at 50% of each subject''s foot length was initially measured and then again immediately following the application of the tape. These measurements were repeated four hours later immediately prior to running two miles on a treadmill, again immediately after running, and finally after another four hours.

Results:

The dorsal arch height increased significantly with both the MR6 and MR6+LD taping, but only the MR6+LD remained statistically greater after four hours, a bout of exercise and again at the end of the day. The mean width of the midfoot significantly decreased with both taping procedures. The change in the width of the midfoot remained significantly decreased in both taping conditions after exercise and throughout the day.

Conclusions:

Both taping procedures are able to significantly change the height and width of the medial longitudinal arch of the foot, but the change lasted longer when the two taping procedures were combined.

Levels of Evidence:

Level 3, Prospective Cohort Study     

THE FACTORIAL STRUCTURE OF THE ARABIC VERSION OF THE REVISED COLLETT–LESTER FEAR OF DEATH SCALE

A sample of 209 volunteer Kuwaiti undergraduates responded to an Arabic version of the Revised Collett–Lester Fear of Death Scale with 4 subscales: Death of Self, Dying of Self, Death of Others, and Dying of Others. Reliabilities of the 4 subscales and of the grand total score ranged from 0.75 to 0.92, which is considered adequate. A 4-factor solution was congruent with the allocation of items to 2 subscales (i.e. Dying of Self and Death of Others), whereas the theorized factor structure of the other 2 subscales were only partially supported by empirical analyses. The intercorrelations between the 4 total subscale scores yielded a general factor of death and dying, denoting good factorial validity of the scale.     

THE R?LE OF THE RETICULO-ENDOTHELIAL SYSTEM IN IMMUNITY : II. THE COMPLEMENT TITER AFTER BLOCKADE AND THE PHYSIOLOGICAL REGENERATION OF THE RETICULO-ENDOTHELIAL SYSTEM AS MEASURED BY REDUCTION TESTS.

1. Intravenous injections of India ink into guinea pigs caused a decided drop in the complement titer which set in as early as 15 minutes after the injection, but did not reach its maximum for 3 hours. This drop was followed by a return to normal within the first 24 hours following the injection. 2. India ink mixed in vitro with guinea pig serum adsorbs the complement almost immediately to its full extent. 3. By means of reduction tests (methylene blue and nitroanthraquinone) it was shown that the respiration of the cells of the liver and spleen of guinea pigs was markedly impaired for the first 8 hours, following an intravenous injection of ink. Evidences of a return to normal functional vitality, however, became apparent by the end of the 1st day after the injection.     

WHAT IS THE RELEVANCE OF THE HOPE STUDY IN GENERAL PRACTICE?

The unique findings from the HOPE (Heart Outcomes Prevention Evaluation) study strongly support extending the use of the angiotensin-converting enzyme (ACE) inhibitor ramipril as a preventive agent for patients at high risk of cardiovascular events with normal left ventricular function. In addition, ramipril provides significant benefit in diabetic patients. These findings will impact on how ramipril is used in primary care, where ACE inhibitors are currently underprescribed. Patients reflecting the inclusion criteria of the HOPE study should be considered as suitable candidates for long-term ramipril therapy as an addition to their existing drug regimen. Screening should include control of kidney function (by serum creatinine), particularly within the first two weeks of treatment, in addition to regular monitoring of serum potassium. However, the HOPE study shows that ramipril is well tolerated at high doses and over a long treatment period. The effectiveness of therapy should also be regularly reviewed and dose adjustments made where necessary. If concern remains, referral to a specialist--a cardiologist or a diabetologist--may ultimately be necessary.     

THE EFFECTS OF ANTICIPATION ON THE MECHANICS OF THE KNEE DURING SINGLE‐LEG CUTTING TASKS: A SYSTEMATIC REVIEW

Background

ACL injuries are common in sports, which has resulted in the development of risk screening and injury prevention programs to target modifiable neuromuscular risk factors. Previous studies which have analyzed single‐leg cutting tasks have reported that the anticipation status of the task (pre‐planned vs. unanticipated) has a significant effect on the mechanics of the knee.

Hypothesis/Purpose

The purpose of this systematic review is to assess the effect of anticipation on the mechanics of the knee in the sagittal, frontal, and transverse planes during tasks which athletes frequently perform during competition.

Study Design

Systematic Review

Methods

The following databases were searched using relevant key words and search limits: Pub Med, SPORTDiscus, CINAHL, and Web of Science. A modified version of the Downs and Black checklist was used to assess the methodological quality of the articles by two independent reviewers.

Results

284 articles were identified during the initial database search. After a screening process, 34 articles underwent further review. Of these articles, 13 met the criteria for inclusion in this systematic review.

Conclusions

It appears that tasks which do not allow a subject to pre‐plan their movement strategy promote knee mechanics which may increase an athlete''s risk of injury.

Clinical Relevance

Clinicians involved in the development and implementation of ACL injury risk screening and prevention programs may want to consider incorporating tasks which do not allow time for pre‐planning. These unanticipated tasks may more closely mimic the demands of the sports environment and may promote mechanics which increase the risk of injury.

Level of Evidence

Level 1b     

THE R?LE OF THE MUCOID POLYSACCHARIDE (HYALURONIC ACID) IN THE VIRULENCE OF GROUP A HEMOLYTIC STREPTOCOCCI

1. A quantitative turbidimetric method for the estimation of hyaluronidase activity, based on the ability of the enzyme to decrease the capacity of the polysaccharide to precipitate acidified protein has been developed. Two units of hyaluronidase, by this method, are equivalent to one viscosity-reducing unit. 2. Hyaluronidase added to a phagocytic system containing defibrinated human blood, immune or non-immune, greatly increases the rate of phagocytosis of group A streptococci. Phagocytosis of Type I pneumococci is not affected by hyaluronidase under the same conditions. 3. The bactericidal activity of non-immune blood against group A streptococci is increased by hyaluronidase; the activity of immune blood is, however, somewhat inhibited by the enzyme. Killing of pneumococci is not affected by the presence of the enzyme. 4. Mice can be protected against group A streptococcal infection by frequent treatment with 200 turbidity-reducing units of hyaluronidase; the protective action of the enzyme is removed by heating at 60°C. for 1 hour. Mice infected with Type I pneumococcus and treated with hyaluronidase die somewhat sooner than the untreated controls.     

DOES THE INGESTION OF ALCOHOL INFLUENCE THE DEVELOPMENT OF ARTERIOSCLEROSIS IN FOWLS?

The effect of alcohol ingestion upon the development of naturally occurring and stilbestrol-induced arteriosclerosis was studied in the domestic fowl. In two experiments, a 15 per cent ethyl alcohol solution was used for drinking purposes, and in a third experiment wine containing 12 per cent of it was administered. The caloric intake of both food and alcohol was carefully controlled by pair-feeding, a glucose solution being used for drinking purposes to equalize the caloric intakes of the control birds with those of the alcohol-treated birds. A total of 224 cockrels was studied, and the period of observation for each experiment lasted 12 months. The degree of arteriosclerosis in the thoracic and abdominal aortas was determined in the gross and microscopically, and the degree of lipide infiltration was determined microscopically. The gross grading of arteriosclerotic lesions agreed closely with the microscopic analysis of intimal thickening and lipide infiltration of the arterial wall. The gross gradings were subjected to a critical statistical analysis which allowed precise statements to be made on the probability that a real effect would be overlooked. This analysis yielded no evidence that alcohol or the wine used had affected the degree of gross arteriosclerosis or lipide infiltration.     

THE FACTORIAL STRUCTURE OF THE REVISED COLLETT–LESTER FEAR OF DEATH SCALE

In a study of 144 college students, the factorial structure of the Collett–Lester Fear of Death Scale matched the face content of the subscales quite closely, ameliorating the criticism of the scale by R. A. Neimeyer et al. (2003) Neimeyer, R. A., Moser, R. P. and Wittkowski, J. 2003. Assessing attitudes toward dying and death. Omega, 47: 45–76. [Web of Science ®] , [Google Scholar].     

OBTAINING THE PAST HEALTH HISTORY

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STUDIES ON THE MECHANISM OF THE FORMATION OF THE PENICILLIN ANTIGEN : III. THE N-(D-α-BENZYLPENICILLOYL) GROUP AS AN ANTIGENIC DETERMINANT RESPONSIBLE FOR HYPERSENSITIVITY TO PENICILLIN G

An excess of D-benzylpenicillenic acid (BPE) was reacted with human γ-globulin, human serum albumin, gelatin, and poly-L-lysine in aqueous solution buffered at pH 7.5–8.0. Under these conditions, BPE reacted predominantly with lysine ε-amino groups of the proteins to form the mixture of diastereomers of ε-N-(D-α-benzylpenicilloyl)-lysine groups (Di-BPO-Lys). BPE reacted also, but to a considerably smaller extent, with cystine disulfide linkages of human γ-globulin and human serum albumin to form D-benzylpenicillenic acid-cysteine mixed disulfide groups (BPE-SS-Cys). Conjugates containing large numbers of BPE or D-penicillamine mixed disulfide groups were prepared by reaction of BPE or D-penicillamine with thiolated human γ-globulin under mild oxidizing conditions. Anti-penicillin antibodies were produced in rabbits by immunization with either potassium penicillin G (PG) or a preincubated mixture of PG with normal rabbit serum (PG-NRS) in complete Freund''s adjuvant. Specific precipitation analyses in aqueous and gel media (Ouchterlony), PCA analyses, and specific inhibition of these reactions with haptens were carried out on the rabbit anti-PG and anti-(PG-NRS) sera, using the above conjugates as antigens. The anti-penicillin antibodies were found to be directed against the diastereomeric mixture of N-(D-α-benzylpenicilloyl) groups, predominantly the Di-BPO-Lys groups. By these techniques, no antibodies directed against the BPE-mixed disulfide or the D-penicillamine mixed disulfide groups were detected. Three out of six patients with histories of allergic reactions to PG responded with wheal-and-erythema reactions to the N-(D-α-benzylpenicilloyl) (BPO) groups contained in BPE-human gamma globulin conjugate. Another such patient exhibited serum antibodies specific for the BPO group. One patient being treated with 25 gm per day of PG showed the presence of non-dialyzable antigenic BPO-conjugates in his serum. These results demonstrate that the diastereomeric BPO groups (predominantly Di-BPO-Lys groups) are major antigenic determinant groups responsible for PG hypersensitivity in rabbits and human beings. The possible clinical usefulness of multivalent Di-BPO conjugates and univalent Di-BPO haptens is discussed.     

THE FREQUENCY OF BACILLUS INFLUENZ? IN THE NOSE AND THROAT IN ACUTE LOBAR PNEUMONIA

1. Bacillus influenza is frequently found in association with lobar pneumonia. 2. In lobar pneumonia both Bacillus influenza and pneumococcus are frequently found in the nose. 3. The influenza bacilli found in the upper respiratory tract of cases of lobar pneumonia are of various types. 4. The exact significance of these findings is at the present time not clear.     

THE R?LE OF THE RETICULO-ENDOTHELIAL SYSTEM IN IMMUNITY : VII. THE EFFECT OF LOCAL AND SYSTEMIC BLOCKADE ON THE TOXIC ACTION OF HETEROPHILE (FORSSMAN) SERA IN GUINEA PIGS

1. Guinea pigs blocked by intravenous injection of either India ink or trypan blue succumbed with fatal shock after the intravenous injection of heterophile immune serum, although the time of death was somewhat delayed as compared with normal controls. 2. Local blockade of the skin of guinea pigs with trypan blue inhibited completely the development of the characteristic skin reaction following intracutaneous injection of Forssman serum within the blocked area. 3. Infiltration of the skin of guinea pigs with India ink afforded no protection against the full development of the toxic skin reaction.     

STUDIES ON THE BACTERIOPHAGE OF D'HERELLE : I. IS THE LYTIC PRINCIPLE VOLATILE?

The lytic principle concerned in the phenomenon of transmissible lysis is not volatile. The results which have been taken to indicate volatility are, in our opinion, to be attributed to the transfer to the distillate of minute droplets of the original active filtrate.