Effects of cadaver dissection on the attitudes of medical students

Summary: Summary. A study was conducted to determine whether the attitudes of medical students to death and caring changed during the 3 months following exposure to cadaver dissection. All first-year students were invited to complete a questionnaire immediately before their initial cadaver dissection experience, after 6 weeks, and after a further 3 months. The questionnaire reflected attitudes to death, violent death, death of someone known to the respondent and caring when someone known to the respondent is seriously injured. Ethnicity and previous exposure to dying has no effect on responses, but overall men students' reactions were significantly less than for women ( P < 0.001). The responses given on the final part of the questionnaire after 3 months were significantly lower than those to most questions in the first part of the questionnaire. The exceptions were those questions where the subject in the given scenario was known to the respondent, where reactions were rated significantly greater ( P < 0.001) in the follow-up questionnaire and can be explained on the basis that they were a personal referent.
Students rapidly develop a coping mechanism which enables them to view cadaver dissection as an occupation quite divorced from living human beings. During these early months of training solicitude decreases for those who die who are unknown to them, but concern for personal referents increases. Educators should be aware of the dramatic change of attitudes among students and the process of professionalization which might influence their caring of future patients.     

Cellular degeneration and synaptogenesis in the developing retina of the rat

We have investigated the time course and magnitude of cellular degeneration in the ganglion cell layer and the presumptive amacrine and bipolar regions of the inner nuclear layer during the development of the retina in the rat. Pyknotic profiles are present in the ganglion cell layer during the first 2 postnatal weeks, reaching peak numbers during the first 4 postnatal days (corresponding to the time of greatest loss of ganglion cells and their axons: Potts et al., '82; Lam et al., '82; Perry et al., '83). Two observations suggest that the majority of pyknotic profiles present in the ganglion cell layer during the second postnatal week are not ganglion cells. First, following injection of kainic acid into one superior colliculus, degenerating ganglion cells in the contralateral retina are cleared within 24-48 hours. Therefore, since most ganglion cell and axon loss occurs within the first postnatal week, few of the pyknotic profiles present in the second week are likely to be ganglion cells. Second, the time course of cellular degeneration in the ganglion cell layer during the second postnatal week follows a very similar pattern to that seen in the presumptive amacrine sublayer of the inner nuclear layer. Such a correspondence suggests that two phases of cell death occur in the ganglion cell layer: during the first postnatal week the majority of dying cells are ganglion cells, and in the second, most cell death is due to a loss of displaced amacrine cells. In the inner nuclear layer pyknotic profiles are most numerous in the presumptive amacrine region on postnatal days 6 and 7, and in the presumptive bipolar region on day 10. Synaptogenesis in the inner plexiform layer occurs later but reflects the order of cell death. Thus, conventional (presumed amacrine) synapses were first observed on day 11 and synaptic ribbons (indicative of bipolar synapses) on day 13. These observations suggest that amacrine and bipolar cells initiate synapses only after their numbers have stabilized.     

An immunohistochemical study of MAP2 and clathrin in gerbil hippocampus after cerebral ischemia

Changes in MAP2 and clathrin immunoreactivity were studied in gerbil hippocampus after transient cerebral ischemia. MAP2 immuno-reactivity decreased significantly by 1 h in the subiculum-CA1 and CA2 areas which correspond to reactive change, while no decrease was observed in CA1 until day 4. Before the initiation of delayed neuronal death, MAP2 immunoreactivity was not changed in CA1. On the other hand clathrin immunoreactivity increased in the pyramidal cell layer of CA1 by 3 h after ischemia and remained high for 2 days. Clathrin immunoreactivity in the pyramidal cell layer of CA1 diminished after delayed neuronal death. The transient change of clathrin was noted especially in CA1 in the period prior to delayed neuronal death. These results imply an abnormal change in clathrin turnover after ischemia, which may participate in the pathogenesis of delayed neuronal death.     

急性心肌梗塞猝死的诱因及抢救(附13例报告)

本文报告了急性心肌梗塞猝死13例。分析猝死的诱因主要有血清钾浓度降低,严重心律失常,包括室内传导阻滞、室性并行心律、室性早搏等。近年来急性心肌梗塞的发病率日趋增高,心源性猝死也随之增多,有必要对猝死的诱因进行探讨,以采取有效的抢救措施。     

沙土鼠短暂性脑缺血后海马损伤的形态学特征

本实验通过结扎沙土鼠双侧颈总动脉20分钟,再灌流7天内,动态观察背侧海马组织的形态学变化。光镜观察表明:海马各区对缺血的反应性不同,其中以 CA_1区锥体细胞对缺血最为敏感,并且 CA_1区神经元的损伤是迟发性的,再灌流4天后才出现大量神经元的坏死、消失,即“迟发性神经元死亡”(NDN)。电镜下发现:缺血再灌流早期(1～2天),CA_1区神经细胞质内有大量粗面内质网增多。本实验结果表明:短暂性脑缺血所致的海马损伤与脑组织其他区域神经元损伤不同。     

149例围产儿死亡原因分析

目的：探讨围产儿死亡原因及降低围产儿死亡率的措施。方法：对1994年1月－2001年12月在我院住院分娩的149例死亡围产儿的临床资料进行回顾性分析。结果：围产儿死亡率为22．74‰，死胎率为9．77‰，死产率为3．36‰，早期新生儿死亡率为9．62‰，占42．28％。围产儿死亡原因：缺氧占47．65％，早产占21．15％，出生缺陷占12．08％。结论：加强孕期保健、规范系统产前检查及监护、积极预防治疗妊娠并发症、防治早产、实施正确的新生儿窒息复苏方法、建立NICU等是降低围产儿死亡率的重要环节。     

1600例住院病人死亡原因分析

[目的 ]探讨 160 0例住院病人的死亡原因及其分布特征 .[方法 ]收集 1995年 1月至 2 0 0 2年12月间 160 0例我院住院死亡病人资料 ,对死亡疾病构成比率、男女主要疾病死亡构成比率、汉族和朝鲜族主要疾病死亡构成比率及年龄构成比率进行统计 .[结果 ] 160 0例死亡病例的死亡原因中脑血管疾病占 2 4 9% ,恶性肿瘤占 2 3 4% ,消化系统疾病占 13 7% ,意外伤害和中毒占 10 3 % ,心血管疾病占9 2 % ;男性与女性主要疾病死亡分布不同 ,两者间有非常显者性差异 ;汉族与朝鲜族主要疾病死亡分布不同 ,两者间亦有非常显者性差异 ;年龄构成比中 61～ 70岁居首位 ,占 2 6 6% ,51～ 60岁占 18 0 % ,41～ 50岁占 16 8% ,71～ 80岁占 15 8% ,3 1～ 40岁占 10 8% .[结论 ]住院死亡的疾病构成因性别及民族不同 ,其分布不同     

United states non-Hodgkin's lymphoma surveillance by occupation 1984-1989: A twenty-four state death certificate study

Death certificates from 23,890 male and female non-Hodgkin's lymphoma (NHL) cases and 119,450 noncancer controls from 24 states for the period 1984-1989 were used to generate hypotheses regarding occupational associations. Cases were frequency matched by age, race, and gender with five controls per case. Odds ratios were calculated for 231 industries and 509 occupations. Significant associations were observed for a variety of white-collar professionals (i.e., real estate agents, secretaries, bookkeepers, teachers, postal employees, business agents, engineers, chemists, and medical professionals) and blue-collar occupations (i.e., firefighters, farm managers, aircraft mechanics, electronic repairers, mining machine operators, and crane and tower operators). © 1995 Wiley-Liss, Inc.     

江苏省婴儿死亡漏报情况分析

江苏省婴儿死亡报告工作中，出现漏报率为１７．８７％，婴儿死亡漏报率为２５．６１％，农村出生漏报率和婴儿死亡漏报率均高于城市。婴儿死亡漏报中年龄越小，漏报越多；男女性别之间无显著性差异。城乡婴儿死亡漏报的主要死因是肺炎、意外死亡、新生儿窒息和先天畸形。本文还分析了造成漏报的主要原因，并提出了防止漏报的对策和干预措施。