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At least 973 records · Page 54Linked to original sources
PubMed1999

Evidence for the unique function of docosahexaenoic acid during the evolution of the modern hominid brain.

The African savanna ecosystem of the large mammals and primates was associated with a dramatic decline in relative brain capacity associated with little docosahexaenoic acid (DHA), which is required for brain structures and growth. The biochemistry implies that the expansion of the human brain required a plentiful source of preformed DHA. The richest source of DHA is the marine food chain, while the savanna environment offers very little of it. Consequently Homo sapiens could not have evolved on the savannas. Recent fossil evidence indicates that the lacustrine and marine food chain was being extensively exploited at the time cerebral expansion took place and suggests the alternative that the transition from the archaic to modern humans took place at the land/water interface. Contemporary data on tropical lakeshore dwellers reaffirm the above view with nutritional support for the vascular system, the development of which would have been a prerequisite for cerebral expansion. Both arachidonic acid and DHA would have been freely available from such habitats providing the double stimulus of preformed acyl components for the developing blood vessels and brain. The n-3 docosapentaenoic acid precursor (n-3 DPA) was the major n-3-metabolite in the savanna mammals. Despite this abundance, neither it nor the corresponding n-6 DPA was used for the photoreceptor nor the synapse. A substantial difference between DHA and other fatty acids is required to explain this high specificity. Studies on fluidity and other mechanical features of cell membranes did not reveal a difference of such magnitude between even alpha-linolenic acid and DHA sufficient to explain the exclusive use of DHA. We suggest that the evolution of the large human brain depended on a rich source of DHA from the land/water interface. We review a number of proposals for the possible influence of DHA on physical properties of the brain that are essential for its function.

Animals↗
PubMed1988

Mycobacteria in the light of modern genetics development.

It is generally assumed that genetic research of mycobacteria is delayed as compared with other, more commonly used, bacterial models, particularly in the field of genetic transfers. In the field of mutagenesis the problems have been studied to such an extent that replication maps of the chromosome of M. phlei and M. tuberculosis H37 Rv have already been constructed and a new model of the cell cycle of bacteria exhibiting a slow growth rate has been worked out. When the problems of mycobacterial genetics are looked upon in the light of gene manipulations it may be concluded that mycobacteria belong to a few models whose genes are used for cloning and that problems of practical significance will be studied by means of the most modern approaches.

Genetics, Microbial↗
PubMed1992

The output of four modern vaporizers in the presence of helium.

It has been previously demonstrated that the output of calibrated vaporizers is influenced by the concentration of nitrous oxide in the carrier gas. This study was performed to determine whether helium in the carrier gas affects the output of modern calibrated vaporizers. A factorial design was used to determine the influence of carrier-gas helium concentration, carrier-gas flow rate and vaporizer dial setting on the output of four vaporizers: Ohio Calibrated Enflurane, Ohio Calibrated Isoflurane, Ohmeda Isotec 4, and Dräger Vapor 19.1 Isoflurane. Three vaporizers of each model were tested. Output was converted to % of baseline so that different dial settings could be compared. For a given dial setting, baseline was defined as the output at a carrier-gas flow rate of 3 L.min-1 and helium concentration of zero. The data were analyzed using multiple linear regression. There was an effect of helium concentration on vaporizer output in all models. None of these changes was clinically important, since vaporizer output did not vary by more than +/- 10%, except at high flows and at high helium concentrations with the Ohmeda Isotec 4. It is concluded that these vaporizers can be used safely with helium.

Anesthesia, Inhalation↗
PubMedDate not supplied

Relating undergraduate musculoskeletal medicine curricula to the needs of modern practice.

BACKGROUND: International studies have demonstrated significant discrepancies between undergraduate musculoskeletal curricula and the needs of modern medical practice. AIMS: To determine the prevalence of musculoskeletal disorders in primary care, General Practitioners, assessment of their undergraduate musculoskeletal training and that considered ideal for several clinical skills, and the relative importance of the ability to recognise selected clinical presentations. METHODS: A postal survey of 200 General Practitioners using a detailed questionnaire. RESULTS: The response rate was 50.5%, with respondents being an average 18.5 years in practice. They saw a mean 140.3 patients/week (range 10-270) of which 17.4% presented with musculoskeletal complaints (range 5-50%). Respondents felt their musculoskeletal education was poor, with a significant difference between it and their ideal (p = 0.007). The most important skill for a graduating doctor was history taking, examination and appropriate investigation of a musculoskeletal problem. The most important clinical presentation was recognition of traumatic quadriplegia. CONCLUSIONS: A large proportion of primary care in Ireland is devoted to musculoskeletal complaints, however, there are deficiencies perceived in undergraduate musculoskeletal education. A review of undergraduate musculoskeletal curricula, emphasising the clinically relevant aspects of this discipline is needed.

Clinical Competence↗
PubMed1997

Mhc allelic diversity and modern human origins.

Thirty complete coding sequences of human major histocompatibility complex (Mhc) class II DRB alleles, spanning 237 codons, were analyzed for phylogenetic information using distance, parsimony, and likelihood approaches. Allelic genealogies derived from different parts of the coding sequence (exon 2, the 5' and 3' ends of exon 2, respectively, and exons 3-6) were compared. Contrary to prior assertions, a rigorous analysis of allelic genealogies in this gene family cannot be used to justify the claim that the lineage leading to modern humans contained on average at least 100,000 individuals. Phylogenetic inferences based upon the exon 2 region of the DRB loci are complicated by selection and recombination, so this part of the gene does not provide a complete and accurate view of allelic relationships. Attempts to reconstruct human history from genetic data must use realistic models which consider the complicating factors of nonequilibrium populations, recombination, and different patterns of selection.

Alleles↗
PubMed1998

Genetic structure of the ancestral population of modern humans.

Neutral DNA polymorphisms from an 8-kb segment of the dystrophin gene, previously ascertained in a worldwide sample (n = 250 chromosomes), were used to characterize the population ancestral to the present-day human groups. The ancestral state of each polymorphic site was determined by comparing human variants with their orthologous sites in the great apes. The "age before fixation" of the underlying mutations was estimated from the frequencies of the new alleles and analyzed in the context of these polymorphisms' distribution among 13 populations from Africa, Europe, Asia, New Guinea, and the Americas (n = 860 chromosomes in total). Seventeen polymorphisms older tan 100,000-200,000 years, which contributed approximately 90% to the overall nucleotide diversity, were common to all human groups. Polymorphisms endemic to human groups or continentally restricted were younger than 100,000-200,000 years. Africans (six populations) with 13 such sites stood out from the rest of the world (seven populations), where only 2 population-specific variants were observed. The similarity of the frequencies of the old polymorphisms in Africans and non-Africans suggested a similar profile of genetic variability in the population before the modern human's divergence. This ancestral population was characterized by an effective size of about 10,000 as estimated from the nucleotide diversity; this size may describe the number of breeding individuals over a long time during the Middle Pleistocene or reflect a speciation bottleneck from an initially larger population at the end of this period.

Alleles↗
PubMed2002

[Analysis of the anesthesiologist's vigilance with an eye-tracking device. A pilot study for evaluation of the method under the conditions of a modern operating theatre].

INTRODUCTION: With the inclusion of new monitoring devices over the last two decades, the distribution of the anesthesiologists vigilance has changed which might influence the ergonomic profile of an optimal anesthesia workstation. The aim of this pilot study was the evaluation of an eyetracking device to analyze the vigilance distribution of an anesthesiologist during routine cases in an operating theatre of the 21st century. MATERIAL AND METHODS: Five anesthesiologist with different levels of training were followed during different types of surgery using a video camera-based eye-tracking system. The films were analyzed by an independent observer and rated according to defined regions of interest (ROI). Then typical scan-paths were identified and quantitatively analyzed. RESULTS: The eye-tracking studies proved to be technically of high quality but were time-consuming. Only few disturbances to the operating room (OR) personnel were recorded according to their subjective impressions but bias of behaviour due to the measurement procedure itself cannot be completely excluded. The vigilance of the anesthesiologist towards different factors was dependent on the level of professional training, the type of anesthesia and the type of surgery. Certain factors such as documentation (10-15%) or external disturbances (approximately 20%) proved to be relatively constant. Typical scan-paths could also be identified. CONCLUSION: Eye-tracking studies proved to be a suitable way to analyze the distribution of vigilance of anesthesiologists in a modern operating theatre. For further studies examining the influence of detailed modifications of the OR environment, a standardized study design with the same level of education, the same anesthesia technique and the same surgical procedure needs to be chosen.

Adult↗
PubMed2004

[The Stewart model. "Modern" approach to the interpretation of the acid-base metabolism].

About twenty years ago, Peter Stewart had already published his modern quantitative approach to acid-base chemistry. According to his interpretations, the traditional concepts of the mechanisms behind the changes in acid-base balance are considerably questionable. The main physicochemical principle which must be accomplished in body fluids, is the rule of electroneutrality. There are 3 components in biological fluids which are subject to this principle: a)Water, which is only in minor parts dissociated into H+ and OH-, b)"strong", i.e. completely dissociated, electrolytes, which thus do not interact with other substances, and body substances, such as lactate, and c)"weak", i.e. incompletely dissociated, substances. Peter Stewart strictly distinguished between dependent and independent variables and thus indeed described a new order of acid-base chemistry. The 3 dependent variables (bicarbonate concentration [Bic(-)], pH, and with this also hydrogen ion concentration [H(+)]) can only change if the 3 independent variables allow this change. These 3 independent variables are: 1. Carbon dioxide partial pressure, 2.the total amount of all weak acids ([A-] (Stewart called these ATOT), and 3.strong ion difference (SID). [A(-)] can be calculated from the albumin (Alb) and the phosphate concentration (Pi): [A(-)]=[Alb x (0.123 x pH - 0.631)] + [Pi x (0.309 x pH - 0.469)]. An apparent SID (or "bedside" SID) can be calculated using measurable ion concentrations: SID=[Na(+)] + [K(+)] - [Cl(-)]-lactate. Regarding the metabolic disturbances of acid-base chemistry, according to Stewart's terminology, changes in pH, [H(+)], and [Bic(-)] are only possible if either SID or [A(-)] itself changes. If, for example, SID decreases (e.g. in case of hyperchloremia), this increase in independent negative charges leads to a decrease in dependent negative charges in terms of [Bic(-)] resulting in acidosis (and vice versa). Therefore, according to Stewart, the decrease in SID during hyperchloremic acidosis results from the increase in serum chloride concentration and is the causal mechanism behind this acidosis. Contrary for example, a decrease in [A(-)] (e. g. during hypoalbuminemia) leads to an increase in [Bic(-)] and therefore to an alcalosis (and vice versa). Thus, by Stewart's approach, completely new acid-base disturbances, like "hyperchloremic acidosis" or "hypoalbuminemic alcalosis" (which, of course, can also exist in combination) can be detected, which had been unrecognised by the classic acid-base concepts. Consequently, Stewart's analysis can lead to a better understanding of the mechanisms behind the changes in acid-base balance.

Acid-Base Equilibrium↗
PubMed1997

[Max Brödel (1870-1941): his life and contribution to the development of modern surgery].

Max Brödel (1870-1941), from Leipzig, Germany, is often referred to in the USA as the father of modern medical illustration and mentioned in the same breath as Leonardo da Vinci or Andreas Vesal. After a classical formal art education in Leipzig he worked in Carl Ludwig's laboratory of physiology and anatomy, where he came in contact with American physicians. In 1894, the anatomist F.P. Mall convinced him to work for the recently inaugurated Johns Hopkins School of Medicine in Baltimore, where he collaborated with world-famous surgeons such as H.A. Kelly, W.S. Halsted, and H. Cushing. His illustrations were characterized by meticulous observation, both realistic and explanatory intention, technical superiority, and artistic merit. In 1911 he established the first "Department of Art as applied to Medicine". Here, he proved to be an innovative artist, a creative scientist, and an inspiring and skillful instructor. By the time of Brödel's retirement in 1939, 160 students had graduated as medical illustrators. His pupils spread his principles and style throughout the USA and Canada, and several similar academic programs for medical illustration have been founded in these countries.

Anatomy, Artistic↗
PubMed2002

[From wound healing to modern tissue engineering of the skin. A historical review on early techniques of cell and tissue culture].

The early precursors of modern techniques of keratinocyte transplantation and tissue engineering of the skin are reviewed, starting with histological research into the processes of wound healing and of skin transplantation in the 19th century and continuing with the introduction of cell and tissue culture techniques in early 20th century medicine. The later experimental and clinical application of this research in dermatology and plastic surgery is also explored.

Animals↗
PubMed2005

[Modern mycologic diagnosis. Problems in the daily practice].

Mycological diagnosis is an integral part of dermatology. Modern aspect include not only the identification of causative agents but also sensitivity testing against topical and systemic antimycotic agents and more detailed molecular biological diagnosis using fingerprinting and PCR. In routine practice, the essential question is if a fungal infection is present or not. A positive culture identification should precede use of systemic antimycotic agents especially when dealing with advanced onychomycosis, tinea capitis and chronic candidosis. Determination of resistance is important when dealing with recurrent infections with special candidal species. PCR is most useful in diagnosing otherwise difficult to identify causative agents and in analyzing the chain of infection.

Dermatomycoses↗
PubMed2000

[From scabies room to modern specialty department. 90 years Ludwigshaven Dermatology Clinic].

The dermatology clinic Ludwigshafen was founded in 1910. Dr. Siegfried Fuss was head of the clinic for almost 40 years. The clinic's history reflects the rapid industrial growth of the city, the destruction of two world wars and the progress of dermatology during this century. Today, the clinic is an academic teaching hospital affiliated with the University of Mainz with 45 beds and offers a broad spectrum of modern dematological diagnostic procedures and therapies.

Dermatology↗
PubMed2004

[Modern pharmacotherapy of Hodgkin disease].

High cure rates have been achieved in the treatment for patients with Hodgkin's disease in the past 30 years. Depending on stage at diagnosis and further risk factors up to 95% of patients with Hodgkin's disease can be cured with first-line treatment. Modern therapeutic strategies aim at both reducing therapy-induced late toxicities while maintaining effective tumor control. Patients with early stage Hodgkin's disease are now treated with a short course of chemotherapy for control of occult disease and involved field (IF) irradiation. For patients with early unfavourable stages, effectiveness of treatment shall be optimised by introducing the escalated BEACOPP schedule which has been established in the treatment of advanced stages. Questions to be answered in the treatment of advanced stages concern the optimal number of cycles of an effective chemotherapy regimen and the necessity of additional radiation therapy. The role of erythropoetin and PET-imaging is currently being evaluated in ongoing trials. In the future, new therapeutic approaches with biological agents will be of interest.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2006

[Modern pacing therapy].

Since pacemakers first have been implanted in 1958 considerable technical progress has been achieved. The devices are more efficient today, have complex diagnostic functions, memory capacity and it is even possible to get telemetric software updates. Automatic mode switch due to changing heart rhythm, adaptation of AV-delay, auto sensing and auto stimulation threshold are available and facilitate pacemaker follow up. Because of continuously progress in pacing therapy guidelines have to be updated very often. The newest German and international guidelines for pacing therapy have been published in 2005 by Deutsche Gesellschaft für Kardiologie/ Herz- und Kreislaufforschung (DGK). Indications for pacing therapy increases continuously. Not only bradycardia, but also heart failure, prophylactic pacing to prevent and to terminate tachyarrhythmias are modern fields of pacing therapy.

Bradycardia↗
PubMed1997

[Modern principles in treatment of complex injuries of the facial bones].

Concepts in the treatment of craniomaxillofacial fractures have changed over the last 15 years. Modern imaging techniques have become a central part in establishing a proper diagnosis. Advanced life support and intensive care medicine allow for early primary fracture treatment. The former principles of minimal exposure of bone fragments using small incisions have been replaced by principles from reconstructive craniofacial surgery comprising extensive subperiosteal dissection, exposure of all fracture lines, open reduction and rigid internal fixation. Missing bony structures are replaced primarily by autogenous bone grafts. Using these concepts, most late esthetic and functional sequelae of facial fractures can be diminished remarkably.

Facial Bones↗
PubMed2003

Modern terrestrial analogues for the carbonate globules in Martian meteorite ALH84001.

Modern carbonate globules, located in cracks of submerged volcanic rocks and in calcareous pinnacles in alkaline (sodic) Lake Van, Turkey, appear to be analogues for the approximately 3.9 billion-year-old carbonate globules in Martian meteorite ALH84001. These terrestrial globules have similar diameters and are chemically and mineralogically zoned. Furthermore, they display surface and etching structures similar to those described from ALH84001, which were interpreted as fossilized microbial forms. These terrestrial carbonates formed at low temperatures where Ca-rich groundwaters enter the lake. Chemical, mineralogical, microbiological, and biomolecular methods were used in an attempt to decipher the process responsible for the genesis of these structures. Although the exact mode of formation of Lake Van carbonates remains an enigma, their similarity to the Martian globules indicates that the ALH84001 carbonates may have formed in similar setting on ancient Mars.

Carbonates↗
PubMed2005

The earliest modern mongoose (Carnivora, Herpestidae) from Africa (late Miocene of Chad).

We report on the earliest modern mongooses of Africa, from the late Miocene (ca. 7 Ma) of the hominid locality TM 266, Toros-Menalla, Chad. The material is based on fragmentary dentitions of three individuals. The main diagnostic feature of the Chadian species is the great development of the shear in the carnassials, which distinguishes the Chadian specimens from all extant herpestids except Herpestes and Galerella. In comparison with most extinct and extant Herpestes, the species from Toros-Menalla differs by a markedly smaller size and, depending on the species, relatively more elongated carnassials, more transversely elongated M1 and more reduced p4. On the basis of a great morphological similarity and the absence of significant differences, we assign our material to Galerella sanguinea; the Chadian finding therefore represents the earliest appearance of an extant species of Herpestidae. This record ties the first appearance of the genus to a minimum age of ca. 7 Ma, which is consistent with the estimated divergence date of 11.4 Ma known from the literature for the species of Galerella.

Africa↗
PubMed2002

[Modern nuclear magnetic resonance techniques in stroke].

In industrialized nations, stroke is the most common cause of permanent disability and need of care. Causal treatment is possible only during the first few hours following the stroke, in the form of systemic fibrinolysis. An exact diagnosis of the causative pathology must be made before starting the therapy, and this must happen in the shortest possible period of time. Using imaging techniques, the whole spectrum of differential diagnoses of cerebral ischemia must be covered, including above all intracerebral and subarachnoid hemorrhage. Although computed tomography (CT) is excellently suited for determining hemorrhage, infarct can be recognized with much better contrast using diffusion-weighted magnetic resonance (MR) imaging (DWI). Stroke MR imaging additionally allows the representation of vital "tissue at risk" of infarction using perfusion images as well as the recognition of vessel occlusion using MR angiography. This paper is intended to define the usefulness of DWI in comparison to CT techniques and to elucidate the use of diffusion coefficients for differentiating the various stages of infarction. Besides presenting an explanation of the basic principles of modern stroke MR imaging, typical results of MR perfusion measurements and the appearance of hemorrhages on MR will be explained.

Humans↗