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Facemask general anesthesia is suitable for many minor surgeries but has become unpopular partly because of the laryngeal mask airway. Appropriate facemask anesthesia is safe, effective and cheap, and associated with minimal complications. It also improves the airway management skills of the anesthesiologist. The art and teaching of facemask anesthesia should be encouraged.
OBJECTIVE: To assess the state of the art of fetal magnetic resonance imaging (MRI) in China. DATA SOURCES: Both Chinese and English language literatures were searched in the databases of PUBMED (1998-2005) and CNKI (1998-2005), 41 published articles about fetal MRI were selected. RESULTS: Fetal MRI can serve as an adjunct tool for ultrasonography because of its excellent soft tissue contrast, high spatial resolution, multiplanar capabilities, large field of view and simultaneous visualization of fetal and maternal structures. Since the development of ultrafast MRI sequences provides faster scan time and avoids motion artifacts, it is widely applied in detecting normal or abnormal fetal development, including the central nervous system, thoracic region, abdomen and others. In China, experience in fetal MRI has been scanty, but the technique will be extensively used in the near future because of its multi-faceted advantages. CONCLUSIONS: Compared with ultrasonography, MRI as a complementary imaging for fetal screening is prospective in China or other parts of the world because of its multiple superiorities.
In a recent report, entitled 'Erop of eronder. Financiering van (bio)medisch wetenschappelijk onderzoek' [Sink or swim. The financing of (bio)medical scientific research], the Royal Netherlands Academy of Arts and Sciences has reviewed various aspects of the current financing system. The recommendations concern a funding process with emphasis on open programmes focusing on researcher-initiated research, creating an earmarked budget for matching obligations, creating technology transfer centres offering broad expertise for the validation ofthe scientific results, and giving priority to the establishment of a European Research Council that encourages excellence in fundamental research within the European research area.
In this article we describe and comment upon two graphic art therapy groups. Is it possible to accomplish work of a psycho-therapeutic nature in such groups? We attempt to respond to this question using examples taken from the experience of these different groups. First, we explain how the groups operate, our method of intervention, the general evolution, and finally, we present, in an in-depth fashion, the progress of one of the participants.
The Royal Netherlands Academy of Arts and Sciences (KNAW) has issued a report entitled 'Multifactorial diseases in the genomics era'. It makes two major recommendations. The ministers of Science, Health and Economic Affairs are advised to (a) to take steps to ensure the development, evaluation and implementation of advanced high-throughput technologies in order to improve the international position of the Netherlands, and (b) to actively promote the setting up of one or more general biobanks in the Netherlands that should contain biological samples and data from parts of the population and that are not restricted to a single disorder. The report fails to address some important aspects of biobanks, such as the registration of the ethnicity of patients and controls. In addition monogenetic subvariants in multifactorial disease are not mentioned.
We criticize a view of maternity that equates the natural with the genetic and biological and show how such a practice overdetermines the maternal body and the maternal experience for women who are mothers through adoption and ART (Assisted Reproductive Technologies). As an alternative, we propose a new framework designed to rethink maternal bodies through the lens of feminist embodiment. Feminist embodied maternity, as we call it, stresses the particularity of experience through subjective embodiment. A feminist embodied maternity emphasizes the physical relations of the subjective lived-body rather than the genetic or biological connections. Instead of universalizing claims about the maternal body, embodied maternity looks to communicable experiences and empathetic understanding.
This paper attempts to study the notion of stochazesthai in the Hippocratic Corpus in relation to Hippocratic reflections on the status of the medical art. Considering the passages where the verb stochazesthai is employed, we can see that this word is not yet synonymous with the term "conjecture". The main point of interest are the relations between the Hippocratic writings and the relevant works of Plato and Aristotle. In revising the concept of stochazesthai in this way, it appears that this "conjectural" mode of knowledge was unknown to the Hippocratic writers and that it is really too early in their case to speak of "stochastic medicine".
Reiki is a healing practice, rised in Japan in the mid XI'th century. The philosophy of this art of cure assumes that human health depends on the level and harmonious flow of the vital energy, called "ki". Therefore the main aim of this practice is to remove all energetic blockades in individual's body. Owing to that process the natural, in the practicioners' opinion, human's ability of healing by transfer the ki is restored. Certain steps of initiations increase practitioners skills. In the contemporary euroamerican culture, Reiki has begun to unfold since the beginning of 1970's. Expanding in those days New Age philosophy has supported its adaptation in our society. In Poland this method appeard in the late 1980's and is still rather unknown as a culture occurrence. Author's research, conducted among practicioners' from Olsztyn and Poznań, was to broaden the knowledge about the method and people, who are involved in it. The results show that Reiki is one of the holistic treatment's practices but it has also its unique character. For instance, it assumes the particular role of healer, who is a guide for his patient, helping him to understand and cure himself. According to the practitioners Reiki is the way of comprehensive development, identified with the drift towards holistic health.
Traditional Korean medicine's pronounced impact on Japan came about as a result of Toyotomi Hideyoshi's war on Korea in the late 16th century. The influences of Korean medicine on Japan were caused by the introduction not only of a large number of medical books printed in the Yi dynasty and the techniques of publication but also those of the people of talent. We researched one doctor who came to Japan during the war of the Bunroku periods. The name of the doctor was Kintokuho. He learned medicine from a Chinese, Unkai(YunHai). He caused the iatrogenic diseases in the first year and so he changed his medical prescription to fit Japanese. After this, his treatment produced a curative effect. After his death, his art of medicine was passed on to his pupils.
The temporal lobe epilepsy (TLE) is the most important kind of partial epilepsy both from practical and research point of view, where studies brought many new results in the last years. This article is a state of art review with a special emphasis on medial temporal lobe epilepsy (MTLE). We show the clinical symptoms, EEG and neuroimaging signs, the psychiatric co-morbidities and psyhosocial consequences. Etiological factors, among them hippocampal sclerosis and hippocampal reorganisation is assessed in a more detailed form. The possibilities of pharmacological and surgical treatment are also shown, together with the brief outline of the Hungarian situation. TLE is presented as a model for the development of partial epilepsies.
The art of negotiation permeates every aspect of one's professional and personal life. Nurse administrators who use a scientific method of negotiation to augment professional judgment and decision making can create a climate conductive to success. The author reviews the definition and purpose of negotiation, examines concepts associated with negotiation and communication, analyzes the steps in the negotiation process, relates the negotiation process to the change process, and describes strategies for conducting effective negotiation.
The loading of drugs into ultrafine host vesicles or colloidal capsules in the nanometer size range is an acknowledged technique for the optimization of controlled drug delivery. The main purpose will always be to design inert auxiliary accompanying materials; to use body-friendly and biodegradable excipients; and to miniaturize the drug carrier system dramatically in order to get good stability, excellent absorption, quantitative tissular transfer and, therefore, the expected pharmacodynamic activity. Furthermore, side effects and foreign body irritation should be avoided and a good local and systemic tolerance during and after medication should be a condition sine qua non. The actual state of the art is shown with 4 practical application examples, namely: a cellular uptake by endocytosis and a specific lysosomotropic cell transfer with cell tracer-loaded nanoparticles; the strong immunosuppressive stimulation of nanocapsules--as new adjuvants--when loaded with viral or other antigens; the better blood-brain barrier transfer of an antiparkinson drug when covalently bound to special liposomes; and the use of minivesicles for controlled site-specific anticancer drug release (tumor targeting). In the future, we must find a possibility to deliver the correct dose of the drug precisely to the diseased target organs, tissues or cells of destination, without flooding the organism with massive drug doses. One technologic answer could be the minicarrier concept with specific pathfinders and aspecific pretargeters that serve as switchmen to guide the drug-loaded carrier to the organs, with precise spot landing.
Rehabilitation activities belong to tertiary prevention. The latter includes all measures that aim at avoiding the progression of a physical disability to a handicap, or those that diminish the extent of the handicap. Complex rehabilitation programs represent a cooperation of medical, occupational, and social reintegration. The pertinent state of the art and the unsolved problems are reviewed in this work. In this context, special emphasis is placed on the appropriate division of tasks among rheumatology specialists and general practitioners, as well as others working in the rehabilitation field. In the present decade, worldwide, the need for expanded complex rehabilitation programs will increase markedly.
Adhesive fixed partial denture (FPD) technology has gradually become viable in recent years, suitable for use in general dental practice. The most important prerequisites for success are patient selection and meticulous production techniques. Indications and limits of this technique are evaluated on the basis of the current state of the art. Initial preprosthetic treatment and clinical procedures are described. Research that has been done so far appears to demonstrate that adhesive FPDs are compatible with healthy periodontal tissues, even though some over-contouring of the adhesive tabs on the abutment teeth seems to be unavoidable. First clinical long-term studies have shown, however, that the failure rate of adhesive FPDs is higher than with conventional crown and bridge techniques. Porcelain-fused-to-metal FPDs on pure titanium frames and full ceramic FPDs are new developments in adhesive FPD technology which are not yet fit for use in dental practice.
Computerization and sophisticated radiographic and nonradiographic technology in orthodontics and orthognathic surgery have contributed immensely to the stockpile of knowledge. Yet, in spite of the tremendous technological and scientific advances in these areas, the question of whether treatment planning for orthognathic surgery is an art or a science continues to loom in the minds of clinicians. All too frequently, "scientific" observations do not corroborate clinical findings. The extent to which clinicians are able to rely on current technology is directly dependent on their understanding of its shortcomings. This article examines the limitations of modern technology in clinical diagnosis.
Between November 4, 1984, and September 1, 1988, a total of 16,439 patients were evaluated at the Comprehensive Breast Center at Mount Sinai Medical Center (MSMC) of Miami Beach with clinical examination, state-of-the-art mammography, and, when indicated, complimentary ultrasound mammography. As a result of this, 547 patients had open surgical biopsy, 207 carcinomas were detected in 207 patients, 183 carcinomas (80% of total malignancies) were clinically occult and detected only with breast imaging. Since 207 malignancies were found out of 547 areas examined, our rate was 1 carcinoma in every 2.6 biopsies. One hundred seventy-nine malignant lesions had preoperative needle localization and specimen radiography. Eighty-seven (47%) clinically occult carcinomas were identified because of microcalcifications by mammography alone. Two hundred twenty-six (98%) of the carcinomas were called malignant or suspicious for malignancy with only three (2.4%) false negatives. Twenty-two (10%) patients had axillary lymph-node metastasis. While recent large series report a 15 to 30 per cent rate of carcinoma for nonpalpable, mammographically detected breast biopsy specimens, it is our experience at MSMC with the use of physical exam and mammography, complemented by ultrasound when indicated, that rates of detection of carcinoma are more significantly improved than what the recent literature suggests; therefore, our approach to achieve this better detection will be discussed.
In this paper, the state of the art of the chemical characterization of diesel particulates in Japan is presented. However, some of these results are only preliminary. The principal contents may be summarized as follows: Characterization of Diesel Particulates; Examples of the application of the chemical characterization to various studies are described. Measurements for elemental composition and distributions of molecular weight and boiling point of diesel particulates and related samples were carried out to gain a better understanding of the main components of diesel particulates. Determinations of carbonaceous components, elemental carbon and organic carbon, in diesel particulates were made by a thermal carbon analyzer, and these results were applied to the study of the relations between such components and the driving conditions of diesel vehicles and to the estimate of emission rates of carbonaceous components from on-road diesel vehicles in a highway tunnel. It seems that the thermal carbon analyzer can be used to advantage in the determination of such carbonaceous components. Artifacts of PAH and 1-NP during Collection of Diesel Particulates; In order to minimize the artifacts of PAH during collection of diesel particulates, three methods were investigated for the artifacts of BkF, BaP and BghiP; two methods incorporated the removal of reactive gaseous components such as NO2, with an ACF method and an impinger method, and the third was a high dilution sampling method. These results suggest that the high dilution sampling method is very promising. From the results of various studies including model experiments, it is clear that the artifact formation of 1-NP is of first order dependence on total amounts of nitrate on carbon black and diesel particulates, not on gaseous nitric acid, although second order dependence of the artifact formation on NO2 concentration is ambiguous. Aside from the above studies, the relation between 1-NP concentrations in diesel exhaust and NO2 concentrations in the dilution tunnel with changing the dilution ratio at a fixed driving condition was utilized for an estimate of the artifact formation of 1-NP, and the estimated results are discussed in connection with the reaction order of the artifact formation on NO2 concentration. Concentrations of Various Components in Diesel Exhaust and Ambient Air; Analytical results are presented for the PAH, mononitro-PAH and dinitro-PAH in particulate samples collected from the exhaust of both IDI and DI diesel vehicles and the ambient air in several areas in Japan and China.(ABSTRACT TRUNCATED AT 400 WORDS)
The art of history taking involves the ability to recognize the interrelationship between the details of the medical history and the patient's personal history. For the oral surgeon, this provides important insights into how the patient has reacted to illness in the past as well as how he is most likely to react to current treatment. Specific problems have been reviewed as well as suggested interview techniques to guide the oral surgeon in his management of his patient's reactions. No one expects the doctor to be an iconoclast. He cannot be all things to all patients. He should recognize a problem, acknowledge it as a problem, and be flexible enough to deal with it or refer the patient to someone who can. This kind of understanding will enable the oral surgeon to fulfill his role with appreciation from his patients and an inner sense of professional and personal achievement.