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PubMed2002

Irritation of the human eye mucous membrane caused by airborne pollutants.

OBJECTIVES: The purpose of this study was to investigate the different irritative effects of carbon dioxide and n-butanol exposure on the ocular mucous membrane. MATERIAL AND METHODS: Provocation by the gases was at the same sensory level, which was 50% of maximum on a linear scale. The experiment was performed on nine healthy subjects with the aim of identifying the relationship between eye irritation and the human physiological response to this irritation. A goggle exposure system, invented at the Department of Occupational and Environmental Medicine, Aarhus University, was used for the experiment. The exposures lasted for 30 min each. RESULTS: There were no changes in tear film stability and conjunctival corrosion (lissamine staining) after carbon dioxide and n-butanol exposures leading to 50% sensory eye irritation. However, the study showed a delayed inflammatory response after carbon dioxide exposure when compared with clean air. The significant change was seen for tear fluid neutrophilic granulocytes 22 h after carbon dioxide (CO(2)) exposure only. CONCLUSIONS: It is concluded that the type of exposure made no difference to the elicited physiological responses and that tear film stability and epithelium damage were not affected by sensory irritation itself.

1-Butanol↗
PubMed2006

From Galvani to patch clamp: the development of electrophysiology.

The development of electrophysiology is traced from the early beginnings represented by the work of the Dutch microscopist, Jan Swammerdam, in the 17th century through the first notion of an aqueous transmembrane pore as a substrate of excitability made by Luigi Galvani in late 18th century to the invention late in the 20th century of the patch-clamp technique by Erwin Neher and Bert Sakmann.

Animals↗
PubMed2000

Genes and channels: patch/voltage-clamp analysis and single-cell RT-PCR.

Technological advances in electrophysiology and molecular biology in the last two decades have led to great progress in ion channel research. The invention of the patch-clamp recording technique has enabled the characterization of the biophysical and pharmacological properties of single channels. Rapid progress in the development of molecular biology techniques and their application to ion channel research led to the cloning, in the 1980s, of genes encoding all major classes of voltage- and ligand-gated ionic channels. It has become clear that operationally defined channel types represent extended families of ionic channels. Several experimental approaches have been developed to test whether there is a correlation between the detection of particular ion channel subunit mRNAs and the electrophysiological response to a pharmacological or electrical stimulus in a cell. In one method, whole-cell patch-clamp recording is performed on a cell in culture or tissue-slice preparation. The biophysical and pharmacological properties of the ionic channels of interest are characterized and the cytoplasmic contents of the recorded cell are then harvested into the patch pipette. In a variant of this method, the physiological properties of a cell are characterized with a two-electrode voltage clamp and, following the recording, the entire cell is harvested for its RNA. In both methods, the RNA from a single cell is reverse-transcribed into cDNA by a reverse transcriptase and subsequently amplified by the polymerase chain reaction, i.e. by the so-called single-cell/reverse transcription/polymerase chain reaction method (SC-RT-PCR). This review presents an analysis of the results of work obtained by using a combination of whole-cell patch-clamp recording or two-electrode voltage clamp and SC-RT-PCR with emphasis on its potential and limitations for quantitative analysis.

Animals↗
PubMed2003

Promising new technique in the repair of parastomal hernia.

Parastomal hernia is a common complication after stoma formation. Although not all hernias require surgical repair, a variety of surgical techniques exist. Fascial repair, relocation of the stoma, and the local use of a nonabsorbable mesh are the three major approaches. Despite this variety of techniques, recurrence rate and complications are high. We therefore invented a laparoscopic technique where we close the hernia and reinforce it with a hand-made "funnel-shaped" Gore-Tex dual mesh. This technique has all advantages of laparoscopy (less pain, short hospitalization) combined with the advantages of local mesh repair (no stoma replacement necessary, low recurrence rate). The risk of infection is also minimized. The shape of the Gore-Tex mesh reduces hernia recurrence even more, prevents prolapse, and allows easy colonoscopy and stoma irrigation.

Colostomy↗
PubMed2006

Milestones in endoscope design for minimally invasive urologic surgery: the sentinel role of a pioneer.

Endoscopically based techniques have revolutionized the entire field of surgical specialties over the past 50 years. Currently, minimal access surgery is commonplace for considerable segments of surgical procedures across specialty lines. Central to this revolution, and arguably foremost in its impact on the development of minimally invasive endoscopic surgery, was the development of the rod-lens optical system by Professor Harold H. Hopkins and the almost simultaneous development of the fiberoptic cold-light light source by Karl Storz. It was George Berci who acted as the catalyst in bringing these two men together in the early 1960s, and from that meeting ensued one of the most successful cooperations in the design of endoscopic equipment. Innovative surgeons quickly recognized the enormous potential of these inventions, and in this context, George Berci's work and vision provided the hallmark events leading to the clinical applications from which surgeons and their patients so greatly benefit currently. In urology, Berci's early work has been recognized as a sentinel event bringing endoscopic endoluminal surgery from the lower urinary tract (urethra, bladder, prostate) to the upper urinary tract (ureter, kidney), and eventually to extraluminal laparoendoscopic surgery. This work has been recognized by the Journal of Urology as a "milestone in urology" leading to the clinical application in the field of endoscopic surgery currently referred to as endourology. In this article, the current state-of-the-art urologic surgery for the management of stone disease, urologic tumors, and anatomic abnormalities is presented, which to a great extent has its roots in George Berci's contributions to the field of innovative endoscope design.

Adrenal Gland Neoplasms↗
PubMed2004

Usefulness of the perineum pusher in performing rectal procedures.

We invented the Perineum Pusher to prevent excessive extension of the rectum by elevating the bottom of the pelvis. In the treatment of cancers of the middle and lower thirds of the rectum, a clear operative view can be maintained for a long time by using the Perineum Pusher. Consequently, a sphincter-saving rectal resection with coloanal anastomosis can be performed easily and safely. In addition, intraoperative rectal irrigation can be performed using the Perineum Pusher. No complications resulting from the Perineum Pusher have been experienced in 27 rectal cancer patients. As the Perineum Pusher can be used very simply and effectively in sphincter-saving rectal resections with coloanal anastomosis, this new surgical instrument is therefore highly recommended for use when performing various rectal procedures.

Anastomosis, Surgical↗
PubMed2006

The surgical journal of the future: how will it appear?

Not since the invention of the printing press in 1440 by Johannes Gutenberg has there been such a revolution in the methods of dissemination of knowledge as is now being seen in the electronic media. The time-honored printed journal is becoming obsolete and open-access electronic journals and other technological innovations are rapidly reshaping the field of scientific publication. This paper will explore some of the forces driving these changes and what lies in store for the surgical journal of the future.

General Surgery↗
PubMed1998

Caries removal techniques and instrumentation: a review.

The invention of rotary instruments not only improved the speed of caries removal but also the destruction of sound tooth substance. Hence, as early as the 1950s, there were attempts to develop a less invasive technique, such as the air-abrasive and ultrasonic technique, for the purpose of caries removal. The proposed use of air-polishing was published in the early 1980s. Subsequent better understanding of the carious process saw the introduction of the enzyme technique in the late 1980s. Other techniques, such as chemomechanical caries removal and laser systems, have also been attempted and researched during the last four decades to minimise the unnecessary removal of sound tooth substance, although these and other techniques reviewed in this article have not yet superseded the use of rotary instruments. Furthermore, the concept of micro-cavity preparation developed in recent years and the introduction of acid-etch techniques, resin bonding and the use of glass-ionomer cements have also revolutionised the principles of cavity preparation in conservative dentistry. This article reviews the development of these various caries removal techniques and instrumentation and the evolutionary philosophies of cavity preparation promulgated over the last century or so.

Dental Caries↗
PubMed2000

Only horses and fools.

Narrative format, in the form of an invented short story, is used to convey several essential truths in a didactic essay in Neuropsychiatry. Messages, in memorable form, emerge at several levels. Narrative format is essential in biographical medicine and it could be attractive to students at various levels of learning. There are great values and some dangers in biographical science.

Animals↗
PubMed2004

The evidence thing.

The methodology of evidence-based medicine (EBM) has become dominant in the clinical field to the detriment of historically validated paradigms. The philosophical background of EBM is considered and the strengths and flaws of its main tools (randomized trials and meta-analysis) are reviewed. The structural format of EBM speaks the language of regulators and health planners, satisfies the needs of the academic-industrial complex, and is favored by editors of medical journals. Specific problems of trials of medical versus surgical therapy are noted. The deductive-numerical approach of EBM is a methodology geared to ascertain the most effective management of a condition when the differences observed between the two entities being considered is small. EBM methodology is unlikely to lead to discovery of new diseases or treatments; the latter derive from alert observation and inductive inference. While its contribution to the rigorous analysis of effectiveness of some therapies is acknowledged, EBM is not the nostrum of clinical research. Observational and inductive clinical intelligence should be stimulated and published because a therapy needs to be invented before it is proven effective. Biomathematicians need to improve nonrandomized methodology as they did for randomized studies.

Evidence-Based Medicine↗
PubMed2000

The underestimated advantages of iliofemoral endarterectomy.

Iliofemoral endarterectomy was invented 50 years ago, but it is seldom practiced today for two reasons. The first is that it is technically challenging and the second is that outcome in early series was poor. Our preliminary experience having been more encouraging, we have continued to perform iliofemoral endarterectomy for the past 20 years. The purpose of this retrospective study was to evaluate our results and compare them with results of alternative techniques described in recent literature. We have performed a total of 176 iliofemoral endarterectomies in patients with normal or nearly normal aortas. The procedure involved the entire network including the common iliac artery, external iliac artery, and common femoral artery in 108 cases (group I), the common iliac artery with or without the external iliac artery in 40 cases (group II), and the external iliac arteries and the common femoral artery with or without the deep femoral artery in 28 cases (group III). From our results we conclude that iliofemoral endarterectomy should be used as a first-choice modality in patients with normal or nearly normal aortas who present with iliac lesions that are either too long for balloon angioplasty or impossible to recanalize. It eliminates the risk of graft infection and false aneurysm. Restenosis can be treated by balloon angioplasty. It also saves the cost of a prosthesis.

Adult↗
PubMed2006

Web-based diagnostic imaging service using XML forms.

Traditionally, radiology has been conceived as a support department providing patient scanning services to the other clinical departments in a hospital. However, recent advancements in networking technology and related information systems such as picture archiving and communication system (PACS) and radiology information system (RIS) provide new opportunities for inventing different types of diagnostic imaging businesses such as teleradiology. In this article, we examined the business processes of currently operating imaging centers and proposed a prototype of an information system that can facilitate their workflows in a more efficient way. The principal component of our proposed system is a report management module built on extensible markup language (XML) technologies that allows much flexibility and convenience for both imaging technicians and radiologists.

Ambulatory Care Facilities↗
PubMed2006

Painful sexual intercourse caused by a disproportionately long penis: an historical note on a remarkable treatment devised by Guilhelmius Fabricius Hildanus (1560-1634).

Between 1598 and 1641, the famous surgeon Guilhelmius Fabricius Hildanus (1560-1634) published 600 medical and surgical observations in his Observationum et curationum chirurgicarum centuriae I-VI. One of the case reports bears the title 'Pain and infertility caused by a too large penis.' The woman described in this case report most likely suffered from positional deep dyspareunia. Hildanus invented in 1593 a remarkable made-to-measure device. This device was a very well-considered and faultless curative for the woman's dyspareunia. It seemed that the dyspareunia had a simple cause: the disproportional large penis of the woman's husband. Four hundred years later, Hildanus' forgotten penis shortening device deserves a resurrection in today's medical practice. This remarkable and almost forgotten case report is described and discussed.

Coitus↗
PubMed2005

Characterizing and controlling industrial dust: a case study in small particle measurement.

Instrumentation used to measure characteristics of fine particles entrained in gas or suspended in aerosols provides information needed to develop valid regulations for emission sources and to support the design of control technologies. This case study offers a brief history of "micromeritics," a term used by early researchers to describe the science of small particles, and the related invention of laboratory instruments for characterizing very fine particles. The historical view provides insights into the role that Progressive Era government agencies played in advancing esoteric science and applying this knowledge to the regulation of workplace air pollution. Micromeritics instrumentation developed in conjunction with federal research now has many commercial applications worldwide, with characterizing airborne pollutants only a minor one. However, the continuing advances in the micromeritics field provide important laboratory measurement capabilities to environmental research organizations, such as the National Institute for Occupational Safety and Health (NIOSH).

Air Pollutants, Occupational↗
PubMed2006

The European opposition against the BRCA gene patents.

In 2001, the European Patent Organisation (EPO) granted 3 patents on the BRCA1 gene (EP-B-699754, EP-B-705903, EP-B-705902) to Myriad Genetics. The patents, and the option of the patent holder to strictly exert its monopoly right by requesting that all diagnostic testing be done at its laboratory in the United States, has evoked strong reactions in Europe. Several opposition procedures have been started against these patents. After oral hearings at the EPO in Munich in May 2004, the first patent was revoked due to errors contained in the initially filed sequence. At oral proceedings in January 2005, the other two patents were severely limited in scope. The discussion on inventive step on the cloning of the BRCA1 gene - other than the one that relates to the priority date - has not taken place. In other words, the EPO has not questioned the patentability of this gene per se. The author participated in the hearings in Munich and would like to give the genetic community a firsthand account of the case.

Breast Neoplasms↗
PubMed2005

Replacing the patient: the fiction of prosthetics in medical practice.

The invention of computer simulations used for practicing surgical maneuvers in a video game-like format has an ancestry in the artificial limbs of history and is reflected, grotesquely, in Edgar Allan Poe's short story, "The Man That Was Used Up" (1850). The nineteenth century worked to ensure that the incomplete body did indeed retain a sense of self by creating prostheses to mimic corporeal wholeness. Our present-day technology seems intent on doing precisely the opposite, deliberately fragmenting the body and challenging our understanding of the body and the prosthetic.

Computer Simulation↗
PubMed2005

Peritoneal catheters and related infections.

Catheter related infectious complications (exit-site infections, tunnel infections, and peritonitis) remain the major reasons for technique failure during the three decades since, continuous ambulatory peritoneal dialysis (CAPD) treatment has been first established. Despite improvements in catheter's survival rates, catheter related complications result in an increase in the cumulative patients' morbidity and often leading to the catheter removal. The ideal catheter provides reliable and rapid dialysate flow rates without leaks or infections. Among several types, the double-cuff straight Tenckhoff catheter, developed in 1968, is still the most widely used, although its use is decreasing in favour of swanneck catheters. Although there are only few well-designed trials comparing catheters and catheters related infectious complications, controlling for all other important variables, no difference in these complications among the main types of catheters was seen. The single cuff catheters have been associated with a shorter survival rate and time to the first peritonitis episode than the double-cuff catheters. Also exit-site infections were found to be more frequent and significantly more resistant to treatment with single-cuff compared to double-cuff ones. Finally, better results have been reported with the latest developed presternal peritoneal dialysis catheter both regarding survival rates and exit-site infection and peritonitis rates. Recently a renewed interest in continuous flow peritoneal dialysis stimulated inventions of imaginative, double-lumen catheters since a suitable peritoneal access is a sine qua non condition for the development of this new technique of peritoneal dialysis.

Catheterization↗
PubMed2006

Retroperitoneal lymph node dissection for high-risk stage I and stage IIA seminoma.

INTRODUCTION: The clinical results of radiotherapy in low-stage seminoma are excellent with negligible early morbidity. However, in a long-term follow-up various complications may occur. On the other hand, experience in nonseminomas shows that surgical morbidity has decreased markedly after invention of a nerve-sparing technique. These issues served as a rationale for us to perform the primary retroperitoneal lymph node dissection (RPLND) in seminoma patients. MATERIALS AND METHODS: Fourteen pure seminoma patients (10 high-risk stage I and four with clinical stage IIA) underwent nerve-sparing RPLND from September, 1997 to December, 2002. RESULTS: Pathological evaluation revealed lymph node involvement in three out of 10 clinical stage I and in all four stage IIA cases. The patients' acceptance of the surgery was good. Minor intra- and early postoperative complications were observed in two cases. Antegrade ejaculation was preserved in all patients. No retroperitoneal or distant recurrences have been observed. All patients were free of disease with the mean follow-up period of 56 months. CONCLUSION: The excellent results and minimum morbidity of nerve-sparing RPLND together with the increased concerns on late complications of radiotherapy may turn the preference of surgery in low-stage seminoma into the subject of future discussion.

Adult↗