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PubMed1998

Realizing the promise of the US Food and Drug Administration Modernization Act.

The Modernization Act of 1997 is the result of a partnership between the US Food and Drug Administration (FDA) and the pharmaceutical industry. Highlights of the Act, including agreements on user fees, timely review, pediatric studies, and national registry of clinical trials, are presented. Although progress has been made in each of these areas, this paper concerns the profound impact of combinatorial chemistry, genetic research, and pharmacoeconomics on the FDA, the industry, and the drug development process.

Clinical Trials as Topic↗
PubMed2003

Mendel and modern genetics: the legacy for today.

The legacy of Mendel's pioneering studies of hybridization in the pea continues to influence the way we understand modern genetics. But what sort of picture did Mendel himself have of his work and its ultimate uses, and how does that picture compare with the collection of ideas and methodologies that was put forward in his name and later became known as 'Mendelism'? With genetics standing at the center of our present biomedical and biotechnological research, an examination of the history of our concepts in the field can help us better understand what we should and should not expect from current genetic claims. For that enterprise there is no better starting place than Mendel himself.

Agriculture↗
PubMed1984

Modern developments in histopathologic assessment of uveal melanomas.

Uveal melanoma is the most common primary intraocular neoplasm in adults. Those histopathologic features that distinguish uveal nevi from small melanomas, and those that distinguish highly malignant from less malignant lesions, have been the subject of controversy over the past decades. This controversy arises primarily from the subjective methods by which such histopathologic distinctions are made, and the resulting ambiguities may have misguided the clinician in his management of certain uveal lesions. With methods made possible by modern technology, pathologists can now assess the malignant potential of uveal melanomas by objective measurement of cytologic structures within the tumor.

Cell Nucleolus↗
PubMed2002

Monitoring of free calcium in the neuronal endoplasmic reticulum: an overview of modern approaches.

The concentration of free calcium within the lumen of the endoplasmic reticulum ([Ca2+]L) fluctuates between 100 and 1000 microM. High [Ca2+]L provides an electro-driving force for Ca2+ release and supports high Ca2+ diffusion rate within the endoplasmic reticulum lumen. Fluctuations in [Ca2+]L also regulate numerous chaperones, responsible for postranslational protein processing. Thus, [Ca2+]L integrates various signalling events and establishes a link between fast signalling, associated with the endoplasmic reticulum Ca2+release/uptake, and long-lasting adaptive responses relying primarily on the regulation of protein synthesis. This paper overviews modern approaches for the direct monitoring of [Ca2+]L which rely on three classes of low-affinity Ca2+ probes: ER-targeted aequorin, synthetic fluorescent Ca2+ dyes and GFP-based ER-targeted Ca2+ probes. These techniques, especially as applied to neurones, may substantially widen our appreciation of the endoplasmic reticulum as a universal signalling organelle.

Aequorin↗
PubMed2000

An early antecedent to modern random dot stereograms --'the secret stereoscopic writing' of Ramón y Cajal.

The use of computerized random dot stimuli in modern neuroscience was introduced by Julesz in the 1960s. This method made it possible to study exclusively cortical processing of binocular information by disparity-sensitive neurons, and it has attained widespread use among neuroscientists and psychologists. It is now largely forgotten that in the last century, the famous neuroanatomist Ramón y Cajal had worked on random dot stereograms as a means of encoding written information. A brief note was finally published in a Spanish journal on photography in 1901. We present a translation of this text and summarize the early ideas on random dot stereograms, and we also supply a brief historical account on stereoscopic perception.

Depth Perception↗
PubMed2002

Physiological actions of preservative agents: prospective of use of modern microbiological techniques in assessing microbial behaviour in food preservation.

In this mini-review, various aspects of homeostasis of microbial cells and its perturbation by antimicrobial agents will be discussed. First, outlining the position that the physiological studies on microbial behaviour using the modern molecular tools should have in food science sets the scene for the studies. Subsequently, the advent of functional genomics is discussed that allows full coverage of cellular reactions at unprecedented levels. Examples of weak organic acid resistance, the stress response against natural antimicrobial agents and responses against physicochemical factors show how we can now "open the black box" that microbes are, look inside and begin to understand how different cellular signalling cables are wired together. Using the analogy with machines, it will be indicated how the use of various signalling systems depends on the availability of substrates "fuel" to let the systems act in the context of the minimum energetic requirement cells have to let their housekeeping systems run. The outlook illustrates how new insights might be used to device knowledge-based rather than empirical combinations of preservation systems and how risk assessment models might be deviced that link the mechanistic insight to risk distributions of events in food manufacturing.

Bacteria↗
PubMed1999

The modern synthesis, Ronald Fisher and creationism.

The 'modern evolutionary synthesis' convinced most biologists that natural selection was the only directive influence on adaptive evolution. Today, however, dissatisfaction with the synthesis is widespread, and creationists and antidarwinians are multiplying. The central problem with the synthesis is its failure to show (or to provide distinct signs) that natural selection of random mutations could account for observed levels of adaptation.

Journal Article↗
PubMedDate not supplied

[A personal balance of 25 years of modern health care management in the Spanish Public Health System].

At the beginning of 2002, the transference of authority over public health care services from the Spanish national health System (INSALUD) to all the autonomous communities hitherto lacking this authority closed a period of modern halthcare management in Spain which, nevertheless, had lacked the dynamism and innovative capacity of business management. Despite this, during these 25 years, Spanish healthcare management underwent a spectacular growth. The problems of the Spanish public health system are either linked to the inherent problems of a system of universal coverage, with generous provisions and clear underfinancing, or they are characteristic of an obsolete organizational model in which centers and healthcare professionals lack autonomy, or they are related to users' increased expectations and to the enormous complexity of the medicine of the future. All these questions should be approached from the perspective of a new form of management appropriate to the new century. Despite its serious defects and problems, the public values the Spanish public health system; the main risk is chronic and progressive delegitimization wich causes users to lose faith and trust in the public health system.

Forecasting↗
PubMed2006

[Role of modern cross-sectional imaging in thanatology: a pictorial essay].

The development of new imaging modalities such as computed tomography and magnetic resonance imaging is a new phenomenon in thanatology. The growing accessibility to these technologies allows, under some conditions, the acquisition of cross-sectional images on cadavers. The authors present a practical pictorial review of post-mortem changes and deadly injuries, illustrating the contributions of modern cross-sectional imaging techniques in thanatology.

Adolescent↗
PubMed1997

In defence of andragogy. Part 2: An educational process consistent with modern nursing's aims.

In 1987 the English National Board (1987) made it clear that it supported a move towards an andragogical approach to nurse education. Recently such moves have been questioned as has the validity of andragogy (Darbyshire 1993). In response to such challenges this paper extends some of the arguments made in the article 'In defence of andragogy' (Milligan 1995). It is argued that andragogy provides a framework within which care and other crucial aspects of the nurse-patient/client relationship can be mirrored and thereby facilitated in future practitioners. In the socialization processes inherent in nurse education, care is surely difficult to teach or facilitate unless the philosophy and methods are consistent with such ends. Furthermore, it is frequently argued that as educationalists we need to be consistent in our approach to students with that which we hope to see in their future practice (Bevis & Murray 1990). Andragogy offers a medium through which this can be facilitated. It is essentially a humanistic educational process that values the individual. The power relationship between the educator and student is much more horizontal than is found in the historically common hierarchical educational relationship. An educational process based upon andragogy therefore mirrors important parts of the nurse-patient/client relationship. It offers a theory of education consistent with the aims of modern day nursing practice. We should seek to improve our understanding of andragogy and no longer conceptualize it as one end of a false dichotomy with pedagogy.

Education, Nursing, Baccalaureate↗
PubMed2001

Role of bronchoscopy in modern medical intensive care unit.

This article gives a broad overview of the increasingly important applications of bronchoscopy, flexible (FOB) and rigid (RB), in a modern medical intensive care unit. Special emphasis is made to bronchoscopy use in mechanically ventilated patients. Therapies such as endobronchial stenting and Nd:YAG laser are being used to improve respiratory failure and facilitate weaning from mechanical ventilation. Practical applications of recent advancements in technology (endobronchial stenting, laser therapy, and so forth), the increasing use of rigid bronchoscopy, and the new generation of flexible bronchoscopes like battery bronchoscopes, and ultra-thin bronchoscopes, are also discussed. The risks, potential benefits, complications, and suggested technique of performing bronchoscopy in mechanically ventilated patients are reviewed.

Bronchial Diseases↗
PubMed1999

The health transition, global modernity and the crisis of traditional medicine: the Tibetan case.

The epidemiologic and demographic consequences of the health transition, coupled with worldwide pressures for health care reform according to neoliberal tenets, will create new opportunities, and well as new problems, for organized systems of indigenous medicine. Spiraling costs of biomedically-based health care, coupled with an increasing global burden of chronic, degenerative diseases and mental disorder, will produce significant incentives for the expansion of indigenous alternatives. Yet this expansion will be accompanied by pressures to rationalize and modernize health care services according to the structurally dominant scientific paradigm. Without concerted effort to maintain native epistemologies, indigenous medical systems face an inevitable slide into narrow herbal traditions and a loss of those elements of diagnosis and therapy which may be the most valuable and effective. Analyzing the case of Tibetan medicine and other Asian medical systems, I show how this process occurs and how it is resisted. I conclude by discussing the policy dimensions of this problem.

China↗
PubMed1999

Modernization of medical care in Korea (1876-1990).

This article explores the modernization of traditional Korean medicine in an attempt to answer why Korea has a dual system of professionalized care, and argues that the dual system has been shaped by conflicts between herbal doctors and Western-trained doctors throughout the various stages of historical development. I do not attempt comparisons with other countries, but social scientists have created a large body of work on the interaction between Western and Asian medical traditions in India, China, Japan, and other countries. Korea has been absent from this research. The present essay should draw attention to its sociological relevance.

Delivery of Health Care↗
PubMed2003

[Auguste Lumière, pioneer of the modern cicatrization].

At the "Grand Café" in Paris, on december 28, 1895 Louis and Auguste Lumiere displayed the cinematograph, a technical innovation that revolutionized the nascent motion picture. It was the first public projection of a film. While Louis continues his work on pictures and invents autochrome plates for colour photography, Auguste focused his interests on biology and medicine. Since Ambroise Paré, few doctors have been interested in the healing process. Although Carrel and Lecomte Du Nouy published the first studies in the early twentieth century, Auguste Lumière was a pioneer in the modern research and treatment of wounds. He applied the principles of experimental medicine. In his research he used 44 dogs to study the healing speed and the scar quality in certain areas and under general conditions. In the winter of 1914-1915 he studied in Lyon several hundred wounds of war casualties. In 1922 he established and published in a marvellous book the principles of normal healing. In the department of Pr Leon Bérard he was shocked by the fetidness of the wards where the dried bandages were changed once a week. In 1915 he perfected a revolutionary sterilized "treatment-bandage" consisting of 2 mm stitched gauze saturated with Vaseline and Perou's balsam: the "Tulle Gras. In order to disinfect wounds, he used an iodized solution, sprayed in little droplets. The lives of Auguste and Louis Lumière were full of projects and inventions. When Auguste died in 1954 he had registered more than one hundred patents.

Cicatrix↗
PubMed2003

Serum folate and Vitamin B12 levels in women using modern oral contraceptives (OC) containing 20 microg ethinyl estradiol.

OBJECTIVE: The effects of modern oral contraceptives (OC) on serum concentrations of folate and cobalamin are controversial. STUDY DESIGN: Case-control study on the cobalamin and folate status of 71 healthy female nulligravidae using "low dose" OC for >or=3 months and 170 controls. Factors interfering with vitamin metabolism were thoroughly controlled. Serum concentrations were measured by commercial assays. The results were evaluated using Mann-Whitney's U-test and chi(2) analysis. RESULTS: OC-users showed significantly lower concentrations of cobalamin than controls. The rates of women with reduced, normal, and elevated levels differed significantly. Nine users but no control had frank cobalamin deficiency without clinical symptoms. Folate levels did not differ between the groups. Vegetarian diet, smoking or obesity did not have a significant influence. CONCLUSIONS: Routine measurement of cobalamin or folate in women using "low dose" OC is not warranted. Vitamin supplementation or different contraceptive methods should be considered in women with pre-existing cobalamin deficiency or restrictive dietary habits.

Adolescent↗
PubMed1997

Modern science and the explosion of new knowledge.

The technological evolution of mankind accelerated enormously after the institutionalization of science in the 19th century. In parallel with the vast number of beneficial effects derived from the scientific revolution, the explosion of new knowledge and its centralization in only a few countries has generated a number of complex situations that present major challenges for the modern science. These include the asymmetrical distribution in the planet of young people and science, the super-specialization derived from the information overload and the difficulties in teaching the vast amount of new knowledge generated each year by science.

Journal Article↗
PubMed1999

Partitioning of four modern volatile general anesthetics into solvents that model buried amino acid side-chains.

Partitioning of four modern inhalational anesthetics (halothane, isoflurane, enflurane, and sevoflurane) between the gas phase and nine organic solvents that model different amino acid side-chains and lipid membrane domains was performed in an effort to define which microenvironments present in proteins and lipid bilayers might be favored. Compared to a purely aliphatic environment (hexane), the presence of an aromatic-, alcohol-, thiol- or sulfide group on the solvent improved anesthetic partitioning, by factors of 1.3-5.2 for halothane, 1.7-5.6 for isoflurane, 1.7-7.6 for enflurane, and 1.5-7.3 for sevoflurane. The most favorable solvent for halothane partitioning was ethyl methyl sulfide, a model for methionine. Enflurane and isoflurane partitioned most extensively into methanol, a model for serine, and sevoflurane into ethanol, a model for threonine. Isoflurane also partitioned favorably into ethyl methyl sulfide. The results suggest that volatile general anesthetics interact better with partly polar groups, which are present on amino acids frequently found buried in the hydrophobic core of proteins, compared to purely aliphatic side-chains. Furthermore, if an anesthetic molecule was located in a saturated region of a phospholipid bilayer membrane, there would be an energetically favorable driving force for it to move into several higher dielectric microenvironments present on membrane proteins. The results provide evidence that proteins rather than lipids are the likely targets of volatile general anesthetics in biological membranes.

Amino Acids↗
PubMed2002

Modern approach of diagnosis and management of acute flank pain: review of all imaging modalities.

Acute flank pain is a common and complex clinical problem which might be caused by a variety of urinary and extraurinary abnormalities among which ureterolithiasis being the most frequent cause. Plain abdominal radiographs combined with intravenous urography (IVU) have been the standard imaging procedures of choice for the evaluation of acute flank pain over the last decades. Direct detection of even small ureteral calculi is achieved in 40-60%, whereas using indirect signs such as ureteral and renal pelvic dilatation stone detection is possible in up to 80-90% of all cases. However, IVU might be hampered by poor quality due to lack of bowel preparation, by nephrotoxicity of contrast agents, by serious allergic and anaphylactic reactions in 10% and 1% of the patients, respectively, and by significant radiation exposure. The use of ultrasonography (US) in the management of acute flank pain has been growing and when combining the findings of pyeloureteral dilatation, direct visualization of stones, and the absence of ureteral ejaculation, the sensitivity to detect ureteral dilatation can be as high as 96%. Recently, unenhanced helical CT (UHCT) has been introduced as imaging modality with a high sensitivity and specificity for the evaluation of acute flank pain. UHCT has been demonstrated to be superior since (1) it detects ureteral stones with a sensitivity and specificity from 98% to 100% regardless of size, location and chemical composition, (2) it identifies extraurinary causes of flank pain in about one third of all patients presenting with acute flank pain, (3) it does not need contrast agent, and (4) it is a time saving imaging technique being performed within 5min. Based on the data published, one can predict that UHCT will become the imaging procedure of choice for evaluation of acute flank pain within the next years. The purpose of this review is to critically evaluate the role all imaging modalities available for a modern approach of diagnosis and management of acute flank pain with regard to their sensitivity, specificity, positive and negative predictive values and their complications, toxicicty and morbidity.

Acute Disease↗