Expectant management of deep cerebral venous thrombosis with intraventricular hemorrhage

Limited randomized clinical trial data favor the use of anticoagulation in patients with cerebral venous thrombosis. We present a patient with deep cerebral venous thrombosis in whom anticoagulation was withheld because of coexistent intraventricular hemorrhage. She had a benign clinical course without anticoagulation, suggesting that close observation may be a management option in these patients.     

Quality of life in adult survivors of lung,colon and prostate cancer

In a cross-sectional study design, a disease free sample of 57 lung, 117 colon, and 104 prostate cancer survivors who represented short, intermediate and long-term survivors completed a detailed assessment of quality of life (QOL) and rehabilitation needs using the CAncer Rehabilitation Evaluation System (CARES). Demographic and medical data, social support, and a global QOL rating were also assessed. Lung cancer patients showed no differences in QOL with respect to their period of survival. QOL improved for survivors of colon cancer as they lived for longer periods, but declined with time for survivors of prostate cancer. The best predictor of QOL for all groups was KPS, although other variables such as type of hospital, gender, and work status were predictive for survivors of colon cancer. For survivors of prostate cancer comorbidity with other medical illnesses, time since diagnosis and comorbidity due to psychiatric difficulties were predictive of QOL. All groups had significant rehabilitation problems in the domains of physical, psychosocial, sexual, medical interaction, and marital relationships. Lung cancer survivors had more problems than the other cancer survivors. We conclude that patients who survive cancer do not return to a state of normal health. They demonstrate a variety of difficulties with which they must cope as they continue to survive. Greater efforts need to be made early in diagnosis and treatment to understand rehabilitation problems and target interventions in the hope of reducing later sequelae.Currently in private practice, Glendale, CaliforniaC. A. C. Schag was supported in part by Veterans Administration Health Research and Development Grant 83-002 and in part by Cares Consultants, 2210 Wilshire Blvd., Suite 359, Santa Monica, CA 90403.Address requests for Information about CARES to: CARES Consultants, 2210 Wilshire Blvd., Suite 359, Santa Monica, CA 90403, USA. Tel: (+1) 310-450-7410; Fax: (+1) 310-399-0016     

Serotonergic projections from the midbrain periaqueductal gray and nucleus raphe dorsalis to the nucleus parafasccicularis of the thalamus

By a double-labeling method combining the retrograde tracing of horseradish peroxidase and the immunocytochemical technique, serotonin-like immunoreactive neurons in the midbrain periaqueductal gray (PAG) and nucleus raphe dorsalis (DR) of the rat were observed to send projection fibers to the nucleus parafascicularis of the thalamus bilaterally with an ipsilateral dominance. These serotonin-containing projecting neurons were observed mainly at the middle-caudal levels of the ventrolateral subdivision of the PAG and less at the middle-rostral levels of the DR.     

Stephen Girard (1750–1831): a one-eyed American patriot

Stephen Girard trader, banker, millionaire, and patriot lived 81 full and exciting years. Apparently born with a blind or amblyopic right eye, he emigrated from Bordeaux. France, via Santa Domingo to the United States, and finally settled in Philadelphia, where he developed a successful maritime trade. Ultimately, Girard became the first multimillionaire in the United States. Extremely generous, he often walked from his home in the center of Philadelphia to his farm in what is now South Philadelphia distributing shoes to needy children. Probably Girard’s most heroic gestures were his gallant fight against the yellow fever epidemic in 1793 and his loan to the U.S. government during the War of 1812, which allowed the bankrupt country to continue the conflict and ultimately to win the war. Presented, in part, at the tenth annual meeting of the David G. Cogan Ophthalmic History Society, the College of Physicians of Philadelphia, March 8 and 9, 1997.     

Rejuvenation in the early 20th century

Summary. The first theoretical reflections concerning the relation of hormone production with the ageing process stemmed from Charles Edouard Brown-Sequard (1817–1894). At the age of 72 years he experimented on himself with an injection of animal testicular extract.
The Viennese physiologist Eugen Steinach (1861–1944) gained world-wide acknowledgement for his theory of 'autoplastic' treatment of ageing. He deduced that after vasoligation, an increased incretory hormonal production would ensue following the cessation of the secretory output of the gonads. The first operation was performed in 1918 and resulted in a vasectomy boom over the next two decades.
The Russian Serge Voronoff (1866–1951), working in Paris, was one of the first to transplant testicular tissue from a monkey into a human reproductive gland in 1920. Five years later he had already performed this procedure on 300 patients and attracted patients from all over the world.
In America early efforts of human testicular transplantation were performed by Frank Lydston and V.D. Lespinasse. Steinach's vasoligation was taken over by many American doctors, e.g., Harry Benjamin and Charles H. Chetwood. Among the patients who underwent a rejuvenation operation according to Steinach's method were Sigmund Freud (1856–1939) and the Irish poet and Nobel Prize winner William Butler Yeats (1865–1939). Two caricatures from the German magazine Simplicissimus published in 1927, confirm that the rejuvenation operations were constantly in the limelight of the printed media. From 1935 onwards rejuvenation operations gradually lost their appeal due to the introduction of artificial androgens.     

纤维组织粘合剂的实验研究

本文应用“冷沉淀”法制备纤维组织粘合剂。对纤维组织粘合剂中主要成份和含量进行了测定,并测定了主要理化性质,建立了动物实验模型,观察了实验兔对纤维粘合剂的反应。     

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.     

A Study on Extension－Flexion Dynamic Lumbar Spine Radiographsin Patients with Lumbar Intervertebral Disc Herniation

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Recommendations for educational reform in the United States

This article suggests that the United States educational system needs significant changes. The goal of the article is to present a basic educational philosophy that would facilitate this reform. Specifically, education should be viewed as not only a means to an end that teaches basic skills for employment, but also as a process that enhances social development and self-actualization. Recommendations are offered to achieve this important goal.