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[The progress of the morphological research on the acupoint].

The morphological research of the acupoint began from 1977. The scholars have studied on three main works as following. 1) The sensory organs in the acupoint: The area of acupoint contains free nerve ending, Vater-Pacini corpuclese and muscular spindle. The nerve fibers are I, II, III types, the chief is II. 2) The segmental distributions of afferent neuronal fibers of the acupoint: The evidence of the experimental research has revealed that the fibers of mainly and essential acupoints are definite to be afferent segments. The fibers of the upper and lower limbs acupoints projected into III-IX lamina of the posterior horn of the spinal cord. 3) The mutual intersect in the dorsal ganglia between the segmental distributions of the afferent neurons of viscera and that of acupoints. It is proposed that the mutual intersect between the segmental distributions of the afferent neurons of viscera and that of the acupoints is probable the morphological foundation for the theory of somato-viscera.

Acupuncture Points↗

Pain and the diagnostic process: conceptions and misconceptions.

Pain may be considered a diagnostic alarm that acknowledges but usually fails to determine the etiology of a particular clinical problem. Diagnosis thus involves the extraction of additional information from a patient in order to determine rational bases for treatment. The process is ill-defined and fraught with error unless the diagnostician is aware of all and only the relevant diagnostic alternatives. This list of alternatives plus an appreciation of the likelihood of each possible diagnostic outcome determines the fastest rate that diagnostic information can be processed by any system in the absence of unpredictable events called noise. Human diagnosticians must be fluent in the "language" used to convey the desired information if performance is to be optimized. In general this involves restructuring the diagnostic task into smaller pieces which are easier to digest perceptually. One way to accomplish this is to ignore or eliminate patterns which are either irrelevant or occur so rarely (or so commonly) that they usually have negligible impact on diagnostic performance. The utility of a diagnosis is determined ultimately by the degree to which it influences the health and well-being of both the patient and society at large. Hence, the consequence of a particular disease may offset the low diagnostic yield per examination resulting from a low or high prevalence of the disease. When diagnostic patterns are limited by ignorance to only signs and/or symptoms such as pain, the diagnostic process loses its meaning and treatment decisions are compromised necessarily by uncertainty.

Diagnosis, Differential↗

Subentities within adult primary IgA-nephropathy.

Since its definition is purely descriptive, IgA-nephropathy (IGAN) may comprise more disease entities which share the (epi)phenomenon of mesangial IgA-depositions. IGAN patients with macroscopical hematuria (macro-H) differ from the other IGAN patients in 9 aspects: history, HLA-DR, Gm-allotypes, actuarial kidney survival, initial creatinine clearance, initial proteinuria, initial microhematuria, age at presentation and light microscopy of the renal biopsy. The difference in the last five parameters may either be explained by the existence of subentities or by earlier detection of patients with macro-H. The dissimilarity in the first four parameters can only be due to the former theory. Therefore, we conclude that IGAN probably comprises at least two disease entities.

Creatinine↗

Physiopathology of Fuchs's heterochromic cyclitis.

The aetiopathogenesis of Fuchs's disease is still unknown. Recent findings indicate that the role of the sympathetic nervous system can be excluded and that the theory of heredodegeneration is a more probable explanation. A congenital predisposition to the disease which may possibly be related to some malformation of the iris vessels should be considered. This may explain why the disease is not always unilateral. The recent immunological anomalies found in the aqueous humour should be confirmed. Comparative studies of clinical, vascular, and immunological data could be of great interest in the future.

Autonomic Nervous System Diseases↗

[New horizons in medicine. Complexity and predictability in internal medicine].

Being a highly sophisticated structure, the human body should be considered on a physical level as a whole of inter-correlated non-linear dynamic systems, which are by definition, complex systems because they are always conditioned in their operativity by numerous variables. We must draw attention to the opportunity that within the field of medical science the concept of complexity referring to diagnostic, therapeutic and prognostical problems, is distinct between structural and functional. The functional complexity of a system, a phenomena, an event, MY be recognized in its dynamics, only if analysed using modern methods recently brought to light, on the relationship which exist between classic determinism and deterministic chaos. Furthermore, also on practical level, the recent discoveries on the general principles, which are at the base of the functional complexity of non-linear dynamic systems, demonstrate exactly how fragile is the probabilistic predictability which guides a doctor in clinical reasoning in all its various stages; in the gathering of anamnestic and objective data; in the programming the researches aimed at confirming the validness of the diagnosis; in the therapy aimed at reaching the best possible results; in the prognosis which summarize the destiny of the binomial patient illness. The scientific enunciate of universal nature, which demonstrate how, from a tiny uncertainty in the initial functional data of a system, of a phenomena, of an event can unleash a condition of absolute unpredictability, find daily confirmation in both clinical and experimental medicine.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

AANA journal course: update for nurse anesthetists--carbon monoxide poisoning: role of the anesthesia machine's carbon dioxide absorption system.

Carbon monoxide is a colorless, odorless, and tasteless gas that, when inhaled, is toxic to humans. In 1965, Middleton reported the detection of carbon monoxide in the closed anesthetic circuits of patients undergoing surgery. In recent years, anesthesia providers from at least four American hospitals have reported instances of intraoperative carbon monoxide poisoning in anesthetized patients undergoing surgery. Although no deaths were associated with these incidents, carboxyhemoglobin levels ranged from 8.5% to 32%. In virtually all reported cases, the incidents occurred in surgical suites that had not been used for at least 2 days. This facet of the phenomenon advanced the theory that a slow chemical reaction, probably involving soda lime or barium hydroxide lime, was responsible for the liberation of carbon monoxide within the anesthesia circuit. Recent research has attributed this generation of carbon monoxide to the degradation of volatile anesthetic agents by desiccated carbon dioxide absorbents. Although carbon monoxide poisoning of patients undergoing anesthesia with volatile anesthetics is probably a rare occurrence, it is a potential problem for all anesthesia providers.

Absorption↗

Modelling cardiac patient set residuals using rough sets.

Many medical studies deal with the assessment of the prognostic or diagnostic power of some particular test with respect to some particular medical condition. However, even though a test is deemed to be powerful in this respect, the test may not be strictly needed to perform for everyone. If the test is costly or invasive, this issue is of particular interest. This paper presents a methodology based on rough set theory and Boolean reasoning that can be used to identify those patients for whom performing the test is redundant or superfluous. Furthermore, the methodology enables one to automatically construct a set of descriptive and minimal if-then rules that model the patient group in need of the test. A reanalysis of a previously published real-world dataset of patients with chest pain is used as a case study.

Coronary Disease↗

[How old can one become?].

We recorded the highest age at the time of death for both men and women in Norway for the years 1970 to 1995. During this period longevity increased by approximately one year; for women from 106 to 107 years and for men from 105 to 106 years. Based on Gumbel's theory, we have estimated the most probable highest age for the next 10, 20, and 100 years. For women this was found to be 109, 110 and 113 years, respectively; for men the corresponding ages were 108, 109 and 112 years. Our aim must be that as many men and women as possible live to a high age, that their latter years are meaningful, and that they enjoy a high standard of living.

Aged↗

[Diabetic neuropathy: vascular disease?].

INTRODUCTION: The major neurologic complications of diabetes are: 1) Neuropathy, both peripheral and autonomic, with principal manifestations in the lower limbs; 2) Microvascular disease, mainly affecting the retina, resulting in blindness; and 3) Macrovascular disease, presenting with atherosclerosis in the cerebral arteries causing ischemic cerebrovascular disease and stroke. METHOD: The definition of diabetic neuropathy has changed over the last 50 years. Over the last 20 years there have been three main pathogenetic theories to explain diabetic neuropathy: the polyol pathway theory, the microvascular theory, and the glycosylation end product theory. It is apparent that several pathophysiologic factors probably operate simultaneously, and it may be too simplistic to attempt to explain the many clinical and pathologic findings of diabetic neuropathy through a single theory. Diabetic peripheral neuropathy is not caused by large vessel peripheral vascular disease, however, it does appear that small vessel disease plays a role. CONCLUSION: It seems likely, that microangiopathy on the one hand and changes of various metabolic pathways due to hyperglycemia on the other hand are much more related to each other than it was suggested previously.

Blood Vessels↗