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The role of hysterosalpingography in modern gynaecological practice.

A retrospective review of hysterosalpingography (HSG) in a major gynaecological centre was carried out. 324 patients attended (95%) for HSG out of 341 patients referred for this investigation. 189 examinations (58.3%) were abnormal. The requests and radiological findings were reviewed and the results compared with laparoscopy. HSG remains an integral part of gynaecological investigation and its value has not diminished in modern practice.

Adult↗

Radiographic features of anterior buccal mandibular depression in modern human cadavers.

The anterior buccal mandibular depression (ABMD) becomes significant when evaluating edentulous patients prior to implant insertion. The features of the ABMD in dry mandibles from ancient populations have been reported. In the present study the prevalence and radiological appearance of the ABMD and the influence of soft tissue superposition on its radiological detectability in the jaws of modern human cadavers were evaluated. The prevalence of ABMD was 32%. The presence of soft tissue significantly influenced the radiopacity of the ABMD area and the degree of definition of the borders (p=0.0003 and 0.0001 respectively). Changes in the trabecular pattern were observed in 36% of the cases without soft tissue compared with 29% with soft tissue. The ABMD was more readily detected on CT scans than on conventional periapical or panoramic radiographs.

Age Distribution↗

[Detection of impaired renal function: is the modern serologic marker cystatin C more accurate than the 99mTc-MAG3 clearance?].

AIM: Renal function is usually determined by means of creatinine-clearance, and of serum Cystatin C, the latter with increasing frequency. The present study analyses, whether the diagnostic accuracy of (99m)Tc-MAG(3) clearance is comparable to that of these modern serologic methods. PATIENTS, METHODS: 71 consecutive adult Caucasian patients (42 female, 29 male; age 50 +/- 16 yrs., range 20-83) who were referred to a nuclear medicine department for determination of bilateral renal function with (99m)Tc-MAG(3) were included. Following sufficient hydration, 10 ml of blood were taken for determination of Cystatin C and creatinine in serum prior to i.v. injection of the radiotracer. According to the recommendations of the National Kidney Foundation, glomerular filtration rate (GFR) was calculated from serum creatinine using either Cockcroft & Gault and Modification of Diet in Renal Disease (MDRD) study equation. These estimates of GFR served as reference. Cystatin C is a low molecular protein produced by all nuclear cells and is eliminated to 85 % by glomerular filtration. Analysis of (99m)Tc-MAG(3) clearance was performed by means of Bubeck's formula. RESULTS: Linear regression analysis produced Pearson's correlation coefficients of r = 0.68 and r = -0.69 for the comparison of either Cystatin C and (99m)Tc-MAG(3) clearance with the Cockcroft & Gault equation. The comparison of Cystatin C and (99m)Tc-MAG(3) clearance with MDRD study equation resulted in correlation coefficients of r = 0.755 and r = -0.77. None of these differences were significant. The exclusion of renal impairment or the detection of an at least moderate renal impairment revealed again no significant differences between Cystatin C and (99m)Tc-MAG(3) clearance. CONCLUSIONS: Cystatin C and (99m)Tc-MAG(3) clearance are equally suited to exclude renal impairment or to detect a relevant renal impairment. Differences between both procedures are more likely a result of the applied reference method.

Adult↗

The three modern faces of mercury.

The three modern "faces" of mercury are our perceptions of risk from the exposure of billions of people to methyl mercury in fish, mercury vapor from amalgam tooth fillings, and ethyl mercury in the form of thimerosal added as an antiseptic to widely used vaccines. In this article I review human exposure to and the toxicology of each of these three species of mercury. Mechanisms of action are discussed where possible. Key gaps in our current knowledge are identified from the points of view both of risk assessment and of mechanisms of action.

Animals↗

Historical and modern epidemiological studies on populations exposed to N-substituted aryl compounds.

The historical exposures to aromatic amines of various occupational groups are briefly reviewed. Modern studies indicate that other occupational groups might have risks worth investigating; these include machinists and workers in the chemical industry. Details of a recent investigation into the exposure of dye workers are given which indicate a lowered risk in recent years since the introduction of safety measures. Nonoccupational exposures to the aromatic amines are also discussed. They include cigarette smoking and phenacetin abuse, the former being a potent causal agent in bladder cancer.

Amines↗

3M Tegapore: the case for a modern wound contact material.

Wound contact materials have long been viewed with suspicion: the tendency of granulation tissue to grow into gauze materials, and outdated practices such as wet-to-dry dressings for debridement mean that they are associated with pain and trauma at dressing change. Modern wound contact materials, however, have been designed to avoid these difficulties, and there are a growing number of case reports that support their use in planned wound care interventions. This article examines the case for the use of Tegapore trade mark wound contact material as part of the treatment of long-lived and complex wounds.

Aged↗

Role of ethics in modern healthcare: 1.

What is ethics and where does it leave the individual conscience-controlled practitioner? In this, the first of two articles on ethics in modern healthcare, the former question is examined.

Bioethical Issues↗

Day case surgery: a modern view.

For several decades day surgery clinicians have championed the invaluable contribution that can be made to the provision of elective surgical care. It is now acknowledged as high impact change number one: treat day surgery rather than inpatient surgery as the norm for elective surgery. However, the potential is much greater and ambulatory practice will be the vanguard for modernizing the delivery of all surgical services of the future. It has been described as crucial to the future of health care.

Ambulatory Surgical Procedures↗

Modern dressings: healing surgical wounds by secondary intention.

There is a lack of robust research evidence on many aspects of wound care. The inaugural Professional Select Committee on Wound Care, held at the Royal College of Surgeons, explored the relative value of modern and traditional dressings in treating wounds healing by secondary intention. This article outlines its main findings.

Bandages↗

Sodomy and heresy in early modern Switzerland.

The author compares records, from the early modern era, of sodomy trials in two parts of French Switzerland (Geneva, a Protestant city, and Fribourg, A Catholic pastoral area) and presents evidence that: (1) men charged with "sodomy" were prosecuted more often for homosexuality in cities and for bestiality in rural areas, (2) male homosexual subcultures were associated with the growth of large urban centers, (3) sodomy was punished with greater severity than any other crime than infanticide, (4) in both Geneva and Fribourg repression of sodomy increased during periods of religious zeal. With the advent of the Enlightenment, the number of sodomy trials fell as prosecutions for crimes of personal violence declined and prosecutions for crimes against property increased. This is the first English translation of Monter's article, originally written in French.

Capital Punishment↗

State policy, popular discourse, and the silence on homosexual acts in early modern Sweden.

In Sweden, homosexual acts between men were mentioned in secular law for the first time in 1608. Despite the explicit criminalization, very few trials are known from the seventeenth and eighteenth centuries, and the new National Law Code of 1734 contained no sanction at all. The central issue of this essay is how the insignificant number of court cases and the seemingly very limited judicial interest in the issue of sodomy in Early Modern Sweden should be interpreted. The silence of the new law is explained by a shift in the official policy from deterrence to a policy of silence, but the low number of court cases was foremost dependent on a lacking actualization and problematization of homosexual acts in the Swedish popular discourse on sexuality, gender, and prestige. Finally, it is argued that this undeveloped popular discourse probably also corresponded to a meagre and rather restricted sexual practice.

Female↗

Creating their own private and public: the male homosexual life space in a Nordic city during high modernity.

In this article I describe the male homosexual life space in a Nordic city during the decades around the Second World War. It consisted almost entirely of outdoor places such as parks, public conveniencies, and streets. It included, in Delph's (1978) words, not only erotic, but also cultural and social oases, fostering an extensive and varied social life and a growing community. Most of this outdoor space was invisible to those other than the participants. It had its own differentiation of, and meanings for, "public" and "private." A poor economy, overcrowding, and the classical modern city helped shape the location and design of the male homosexual life space, as did the participation of many men who did not look upon themselves as "homosexual." During this period, and especially after the Second World War, this life space began to change in a direction pointing towards that of today, that is, towards less outdoor life and more life in homes and semipublic indoor spaces. Better economy, the rise of the welfare state, and diminished overcrowding furthered this movement. Among other things, these changes stimulated the withdrawal of men who did not see themselves as "homosexual." The transformation of the city into the spread out, suburbanized city, with segregation of various functions, contributed to the development, as did the obstruction of parks and toilets as meeting places by public authorities. The law reform of 1944, which decriminalized homosexual erotic acts between adults, was also of importance.

Adolescent↗

Modern splinting bandages.

We have assessed the current range of synthetic splinting bandages, using physical and mechanical tests and the subjective opinions of patients, volunteers and orthopaedic staff. Modern bandages have some better properties than standard plaster bandage but do not conform as well, are more expensive, and potentially more hazardous.

Bandages↗

The health care experiments at Many Farms: the Navajo, tuberculosis, and the limits of modern medicine, 1952-1962.

In January 1952 a team of medical researchers from Cornell Medical College learned that tuberculosis raged untreated on the Navajo Reservation in Arizona. These researchers, led by Walsh McDermott, recognized a valuable opportunity for medical research, and they began a ten-year project to evaluate the efficacy of new antibiotics and test the power of modern medicine to improve the health conditions of an impoverished rural society. The history of this endeavor exposes a series of tensions at the heart of medical research and practice. Researchers exploited the opportunities made possible by the ill-health of a marginalized population, but did so with the cooperation and gratitude of the Navajo. They introduced new antibiotics that liberated patients from hospitals, but erected an intrusive system of outpatient surveillance. They provided innovative health-care services, but failed to reduce the dominant causes of morbidity and mortality. As every act of treatment became an experiment, they risked undermining the trust on which research and clinical care depended.

Antibiotics, Antitubercular↗

Motus Tonicus: Georg Ernst Stahl's formulation of tonic motion and early modern medical thought.

This paper places in multiple contexts Stahl's formulation of tonic motion, a contractive and relaxative movement of body tissues that was thought to moderate the circulatory blood flowing through their porous structure. The paper analyzes Stahl's theory, elucidates its role in connecting his physiology and pathology, and situates its formulation in his conceptual development as well as the intellectual history of early modern medicine. The theory was at first a post-Harveyan attempt to explain occasional uneven blood flows; it was then expanded to account for the mechanism of blood circulation and metabolism, and formed a fundamental part of Stahl's effort to present a theory of animal heat and fever that would replace the traditional Galenic and fermentational theories. Tonic motion constituted the most important device that counteracted the ineluctable, unceasing corruption of the body, as dictated by its chemical nature; it thus qualified as the preeminent form of what Stahl considered vital motions.

Blood Circulation↗

Demons, nature, or God? Witchcraft accusations and the French disease in early modern Venice.

In early modern Venice, establishing the cause of a disease was critical to determining the appropriate cure: natural remedies for natural illnesses, spiritual solutions for supernatural or demonic ones. One common ailment was the French disease (syphilis), widely distributed throughout Venice's neighborhoods and social hierarchy, and evenly distributed between men and women. The disease was widely regarded as curable by the mid-sixteenth century, and cases that did not respond to natural remedies presented problems of interpretation to physicians and laypeople. Witchcraft was one possible explanation; using expert testimony from physicians, however, the Holy Office ruled out witchcraft as a cause of incurable cases and reinforced perceptions that the disease was of natural origin. Incurable cases were explained as the result of immoral behavior, thereby reinforcing the associated stigma. This article uses archival material from Venice's Inquisition records from 1580 to 1650, as well as mortality data.

Catholicism↗

Caught between the old and the new--Walther Straub (1874-1944), the question of drug receptors, and the rise of modern pharmacology.

This paper deals with an important development of scientific pharmacology, focusing on the reaction of the German pharmacologist Walther Straub to the receptor concept, which was a new approach to explain the binding of drugs to cells in the young discipline of pharmacology after 1900. The article analyzes how Straub as an important representative of his field between 1900 and 1944 was influenced by nineteenth-century thinking, and how he developed a rival physical theory to combat the receptor concept. Straub is seen as a man of transition, who on the one side tackled a core question of drug research with modern experimental methods, but on the other side was hardly able to accept new results in chemistry.

Animals↗