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PubMed2001

Two steps forward, one step back; paradigmatic changes in psychiatry.

The initial scientification of psychiatry after the European discovery of psychotropic drugs via psychopharmacology and biological psychiatry has gradually ended in an impasse. As a result of at least four developments, psychiatry is re-orientating in a more dimensional and functional direction in order to adapt to the progress in the neurosciences. Rigid adherence to nosological systems should be replaced by a careful observation and description of psychopathology as well as a search for relevant psychological dysfunctions and their putative pathophysiological basis. Psychotropics have to be developed that do not suppress symptoms but promote potentially intact functions. Emphasis should be given to the brain mechanisms that are involved in habit formation and chronicity. Modern genetics will drive the discipline towards early intervention and prevention and will elucidate the relations between genetic disorders and the behavioural phenotype. The basis, however, remains clinical observation, dynamically reshaped by neuroscience.

Antipsychotic Agents↗
PubMed1992

Achieving world class performance step by step.

Bridgestone of Japan acquired Firestone, a United States corporation, in early 1988. This article describes the integration process of the two organizations' cultures. There are many lessons in the approach that should apply to a variety of organizations. The Strategic Improvement Process, a rather highly structured approach, harnesses the strengths of both the Japanese and American organizations and starts the manufacturing and technical departments on the road to excellence.

Cross-Cultural Comparison↗
PubMed1984

Step-by-step analysis of adhesion of human platelets to a collagen-coated surface defect in initial attachment and spreading of platelets in von Willebrand's disease.

Adhesion of platelets from the platelet-rich plasma (PRP) of patients with von Willebrand's disease (vWD) and healthy donors has been studied in a simple model system - wells of multiwell tissue culture plates coated with fibrillar calf skin collagen (CSC). This model is characterized by: (i) the presence of only one constituent of the vessel wall connective tissue matrix (collagen), (ii) the absence of surface-bound aggregates and thrombi, (iii) absence of overlapping of neighbouring spread platelets. A morphometric quantitation of adhesion by scanning electron microscopy (SEM) has been carried out. It allows to subdivide this process into three stages: 1) initial attachment of unspread platelets to the substrate, 2) platelet spreading on the substrate, and 3) attachment of unspread platelets to the upper surface of spread platelets. It was established that the PRP of vWD patients, compared to that of healthy donors, is characterized by a decreased total adhesion of platelets to a CSC-coated surface, which is manifested in the impairment of both the initial attachment and subsequent spreading of platelets. Addition of platelet-free plasma from healthy donors to the vWD PRP completely restores platelet spreading on collagen but little affects the initial attachment. These experiments performed on isolated collagen preparations provide further evidence for the initial attachment and spreading of platelets on collagenous constituents of the subendothelium being factor VIII/von Willebrand factor (FVIII/vWF)-dependent. In contrast to the adhesion on the collagen substrate, the adhesion of platelets from vWD PRP to a foreign surface, polystyrene plastic of uncoated wells, is the same as that of the normal PRP and, thus, FVIII/vWF-independent.

Collagen↗
PubMed1985

Endometrial carcinoma stage I--comparison of two different treatment regimes--evaluation of risk factors and its influence on prognosis; suggested step by step treatment protocol.

Two hundred twenty-four patients with stage I endometrial carcinoma were treated between the years 1964 and 1978. One hundred and fifteen patients were classified as clinical stage Ia (51.3%) and 109 patients as clinical state Ib (48.7%). For stage Ia the standard treatment protocol was total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH + BSO). In stage Ib disease, preoperative irradiation was performed followed by TAH + BSO after an interval of 4 to 6 weeks. Postoperative irradiation to the pelvis and vaginal vault was given when extrauterine spread was found and in cases of myometrial penetration beyond the inner one-third of the myometrium. At evaluation in May 1983, the rate of disease recurrence in stage Ia was 20% and in stage Ib 9.1%. Five-year survival in stage Ia was 77.3% and 72.4% in stage Ib. Preoperative irradiation was found justified for G3 disregarding the clinical stage, therefore the approach of routine preoperative irradiation in stage Ib is not recommended. The uterine cavity depth was found to be an inaccurate prognostic parameter. According to the data collected in our material the histological grade and myometrial invasion are much better prognostic parameter and should be taken into consideration while planning the treatment regime.

Adenocarcinoma↗
PubMed2004

Making tubes: step by step.

Branched hollow tubes form the architectural basis of many mammalian organs. The growth factor HGF/SF and its receptor, the Met receptor tyrosine kinase, stimulate epithelial cells to undergo tubulogenesis in vitro. In this issue of Developmental Cell, O'Brien et al. (2004) look at temporal regulation and the role of two HGF/SF effectors, the ERK 1/2 MAP kinases and matrix metalloproteases, in this process.

Animals↗
PubMed2006

Two steps forward and one step back? Australian secondary students' sexual health knowledge and behaviors 1992-2002.

PURPOSE: To report on changes in the sexual health knowledge and sexual and risk behaviors of year 10 and 12 Australian school students between 1992 and 2002. METHODS: Surveys were administered at five yearly intervals to a total of 6781 students in 263 government secondary schools in all Australian states and territories. RESULTS: Analysis of data from the three survey administrations shows high levels of knowledge concerning human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), but a small but consistent decline since 1992. Knowledge about sexually transmitted infections and hepatitis remains poor. In 2002, there was an increase in the number of students reporting ever having had sexual intercourse, and this was most pronounced for year 10 students. The number of young men in year 10 who reported having three or more partners had doubled since 1997 to 33%. More year 10 young women also reported having intercourse with three or more partners. Consistency of condom use has improved over time; however, 39% still report condom use only sometimes. CONCLUSION: School-based sexual health education provides a critical basis for ensuring that young people begin to experience sex safely and with an appropriate knowledge base.

Adolescent↗
PubMed2026

How I do it: 3-Suture robotic pyeloplasty: Step-by-step technique.

Robot-assisted pyeloplasty is now a gold standard in the treatment of pediatric ureteropelvic junction obstruction. We describe a standardized "3-suture" technique designed to facilitate the pyelo-ureteral anastomosis. We used this technique in 65 paediatric patients aged 3-17 years. Early major complications (Clavien-Dindo grade III) occurred in 3 patients (4.6%). The median operative time was 150 min. Surgical success was achieved in 96% of cases at a median follow-up of 9.5 months. This 3-suture approach offers a highly reproducible method for robotic pyeloplasty, facilitating accurate anatomical reconstruction with excellent surgical outcomes.

Humans↗
PubMed2005

Raf phosphorylation: one step forward and two steps back.

We understand Raf-1 activation relatively well but know less about how it is inactivated. An exciting study in this issue of Molecular Cell now describes the molecular basis underlying the transient nature of Raf-1 signaling.

Enzyme Activation↗