Norman Cousins Memorial Lecture 1998. Stress, personal relationships, and immune function: health implications.
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With the rapid growth of industrialization in China, occupational and environmental exposure to chemicals has increased in frequency and in types of chemical exposures. A growing number of Chinese researchers are showing a special interest in exploring the effects of chemicals on the central nervous system. This paper presents a comprehensive review of neurobehavioral toxicology in China. It describes research into the "reference values" of the Neurobehavioral Core Test Battery (NCTB) tests, the development and improvement of the computer-administered Chinese version of the Neurobehavioral Evaluation System (NES-C), and exploration of related biomarkers. On the basis of this research, baseline data for the reference values for six subtests of the NCTB were preliminarily recommended. The upgraded NES-C2 has proven to possess higher stability and validity compared with the previous version, NES-C. Biomarkers derived from the changes in levels of neurotransmitter metabolites might be used as supplementary biomarkers of Pb-induced neurotoxicity.
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Following World War II, Vannevar Bush described science as an "endless frontier" that should be made accessible to all Americans. Since then, cardiovascular health has improved markedly, largely because substantial investments in biomedical research led to numerous therapies and prevention strategies for cardiovascular disease. Despite these advances, however, science remains an endless frontier and we continue to face an infinite array of opportunities for improving cardiovascular health. A standard definition for "frontier" is the "farthermost limit of knowledge or achievement". The limits of our knowledge are expanding at an ever accelerated pace. Unfortunately, we do not always apply what we know, and therefore fail to achieve all we could. For example, we have known for two decades that heart attack patients benefit from beta-blockers, but even today, the drugs are not always prescribed. And, health disparities continue to exist among races and communities. Therefore, the "last frontier of cardiovascular health" is the translation and application of our knowledge to improve the cardiovascular health of all people. We will not reach the farthermost limit of achievement without new knowledge. But, in our zeal to expand our knowledge of cardiovascular diseases, we must remember to ensure that what we learn is rapidly applied to improve cardiovascular health.
The cerebral capillary circulation exhibits heterogenous perfusion and undergoes characteristic changes in the distribution of RBC flow in response to systemic physiological stimuli. Hypoxemia, hypercapnia and hypotension increase the homogeneity of capillary perfusion, which is thought to preserve or enhance transcapillary exchange. Redistribution of capillary RBC flow between nutritive capillaries and preferential channels may contribute to this response. Selective changes in capillary flow may be brought about by non-smooth muscle-based contractile or blood-borne mechanisms. Isovolemic hemodilution anemia increases RBC velocity and supply rate with no decrease in capillary hematocrit. The effect of cerebral ischemia on microvascular patency depends on the severity and time course of the insult and whether the injury is global or focal. Capillary plugging is not observed following transient forebrain ischemia in the rat cerebral cortex but may contribute to tissue injury prior to reperfusion and during prolonged and severe ischemia. In the future, a better understanding of the functional architecture of the cerebral capillary network and its significance in the adaptation to altered circulatory conditions will continue to be an important goal of research. More work will have to be done to (i) substantiate the postulated physiological regulation of cerebral capillary flow, (ii) determine the cellular mechanism of integration of flow-dependent and neuronal activity-dependent signals, and (iii) identify the principal mediators, their cellular sources and molecular targets. The final answer to these questions will in a large part depend on our ability to directly, i.e. microscopically, visualize microvascular, neuronal and molecular phenomena as they occur in the brain in a spatially and temporally distributed manner.
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BACKGROUND: Although a number of diagnostic and therapeutic methods are available to assist the ophthalmologist, relatively little attention has been given to mail consultations. By this method, a clinical summary and photographs, fluorescein angiograms, ultrasonograms, and/or other relevant materials are mailed to a consultant who then renders an opinion by telephone and/or return mail. MATERIALS AND METHODS: The records of all mail consultations that were sent to the senior author and his colleagues during a 20 year period were reviewed to determine the total number of mail consultations, the reasons for the consultations, and the diagnoses and therapeutic recommendations that were made by the consultant. RESULTS: A total of 1357 mail consultations were received during the 20 year period, with a progressively increasing number of consultations each year. Consultations were received from 757 physicians representing all 50 states in the United States and 32 other countries. Because of the authors' subspecialty in ocular oncology and medical retinal diseases, the majority of the consultations received were related to those topics. In many cases, the initial diagnosis and treatment plan were altered based on our opinion through mail consultation. Based on the material received, the recommendations that we made included observation in 635 cases, enucleation in 152, surgical excision of a lesion in 120, plaque radiotherapy in 102, laser photocoagulation in 81, systemic evaluation in 40, external beam irradiation in 36, fine needle aspiration biopsy in 33, orbital exenteration in 25, chemotherapy in 21, and cryotherapy in 14. CONCLUSION: Although not as ideal as direct patient examination, mail consultation can be an effective method of making or confirming a diagnosis and obtaining a therapeutic opinion. Although the authors have received mail consultations related to ocular oncology, this method may be applicable to other subspecialties in ophthalmology and to general medicine.
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Apparently contrasting approaches, ie genetic engineering and screening of new microorganisms, play essential complementary roles to develop current industrial microbiology. Three topics, production and modification of milk-clotting proteinases by genetic engineering, hormonal control of secondary metabolism in streptomycetes, and screening of bioactive metabolites, are introduced as cases of such a hybrid approach, while symbiotic microorganisms are discussed as an example of the vast terra incognita still remaining for the future microbiology.
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DNA technology using DNA sequence polymorphisms has brought a new system to the fields of medicine and forensic science, especially for the studies of genetic diseases and tumor suppressor genes, and for identification of individuals for forensic purpose. Linkage analysis based on segregation of polymorphic alleles in affected families has contributed to identification of many genetic disease. We isolated a large number of polymorphic DNA markers, called VNTR (variable number of tandem repeat) markers and identified the APC gene that is responsible for familial adenomatous polyposis (FAP) by means of a so-called "positional cloning" and characterized germline and somatic mutations of the APC gene in colorectal cancer patients. In addition, we have applied genetic information during colorectal carcinogenesis to sensitive diagnosis of lymph-node metastasis of colorectal cancer.
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