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The Stop Snoring Exercises Program Review

The Stop Snoring Exercises Program Review

The Psoriasis Strategy Review

The Psoriasis Strategy Review

Skinny Fat Shred Review

Skinny Fat Shred Review

Stop Narcissists from messing up your life

Stop Narcissists from messing up your life

Eczema Vanished Review

Eczema Vanished Review

Eye Floaters No More Review

Eye Floaters No More Review

Bad Breath Free Forever Review

Bad Breath Free Forever Review

Hack Your Carbs Review

Hack Your Carbs Review

Paleo Based Meal Planning Guide Review

Paleo Based Meal Planning Guide Review

Cold Sore Treatment Reviews

Cold Sore Treatment Reviews

Power Of Hormones Review

Power Of Hormones Review

Genius Brain Power Review

Genius Brain Power Review

Articles

The Cognitive Behavioural Model Of Bipolar Disorder

Many authors have argued that there is a marked lack of a coherent psychological model of bipolar disorder (e.g., Jones, 2001 Scott, 2001a). Recent research, however, highlights the role of cognitive and psychosocial factors in the development and course of bipolar disorder, and the first treatment manuals were published in recent years, delineating the application of CBT principles to bipolar disorders (Basco & Rush, 1996 Lam et al., 1999 Newman et al., 2002 Scott, 2001b). A body of...

The Self Defeating Masochistic Personality

Life is tough enough without making things even more difficult. Some people, however, deliberately put obstacles in their own way, seem to court suffering, and need to fail. Such individuals are called masochistic personalities, though they were termed self-defeating personalities in the DSM-III-R. Cursed with an uncanny sense for defeating themselves, they routinely set sail for stormy weather and call down setback, loss, frustration, and grief on themselves. When they do experience good...

Nonmyelinated nerve fibres

Vertebrates have two main types of nerve fibre, the larger fast-conducting axons, 1 to 25 fxm in diameter, being myelinated, and the small slowly conducting ones (under 1 fxm) being non-myelinated. Most of the fibres of the autonomic system are non-myelinated, as are peripheral sensory fibres subserving sensations like pain and temperature where a rapid response is not required. Almost all invertebrates are equipped exclusively with non-myelinated fibres, but where rapid conduction is called...

Effects Produced By The Parasympathetic Nervous System

The parasympathetic physiological activity on the organs is generally the opposite of the sympathetic with a few exceptions. The effect of the parasympathetic nervous system effects on some areas of the body are listed below a. Eye (Pupil). Contraction of the pupil (miosis) is produced by parasympathetic stimulation. b. Heart. The parasympathetic nervous system produces a decrease in heart rate and a slight decrease in the contraction strength of the heart. c. Bronchi. The bronchi are...

Restrictive Lung Disease

Restrictive lung disease is another category of pulmonary disorders that may require nocturnal PAP therapy. Lung restriction is most commonly seen in obesity, kypho-scoliosis, neuromuscular disease, interstitial lung disease, and pregnancy. PAP therapy should be used unequivocally in these patients if they have coexisting OSA. However, in the absence of OSA, PAP therapy must be considered on a case-by-case manner, depending upon the disease process being considered. Obese patients without OSA...

The Sadistic Personality

When most of us think of sadism, we think of either the violent psychopath or the use of dominance and pain to accentuate sexual pleasure. But there is a difference between sadistic behavior and a sadistic personality. Although psychopaths can be instrumen-tally aggressive and hostile to the point of murder, only when the knowledge that others are suffering gives the individual pleasure does behavior become sadistic. And only when the inflicting of psychological or physical pain becomes the...

Lymph Node Metastases

Since lymphatic tumour spread is common in pelvic malignancy, it is important to identify the anatomical location of all the pelvic nodal groups and to be aware of the usual pathway of lymphatic drainage for each organ involved. There are perivisceral nodes in the meso-rectal fat, parametrium, and paravesical fat. While meso-rectal lymph node metastases are often identified in rectal cancer, the other perivisceral nodes are only rarely seen. Nodal metastases are most frequently identified in...

Media Fills in Validation of Aseptic Processes

The Guideline on Sterile Drug Products Produced by Aseptic Processing FDA, 1987 refers to media fills as an acceptable method of validating the aseptic assembly process. By 1994, the Guideline to Industry for the Submission Documentation for Sterilization Process Validation in Applications for Human and Veterinary Drug Products FDA, 1994 said that specifications for media fills should be among the information submitted in support of sterility assurance for products manufactured by aseptic...

Overview of nutrition and lipogenesis

Lipogenesis encompasses the processes of fatty acid synthesis and subsequent triacylglycerol synthesis, mainly from excess carbohydrate in the diet. The main sites of lipogenesis are liver and adipose tissue. A detailed overview of lipogenesis and other processes of lipid metabolism is presented in Chapter 1 and here only some specific aspects will be addressed. In humans, the main site of de novo synthesis of fatty acids is the liver. Fatty acid synthesis requires NADPH, acetyl coenzyme A...

Fat metabolism during endurance exercise

The activity of muscle hexokinase is sufficient, in principle, for all the energy for sustained aerobic exercise to be derived from uptake of plasma glucose. In fact, as we have seen, this would reduce the length of time during which the exercise can be sustained at the highest rate. Simultaneous oxidation of glucose and fatty acids therefore produces the longest possible period of sustained high intensity exercise. The availability of fatty acids to the muscles also reduces the rate of glucose...

Definition of resistant starch

From a nutritional perspective, starches can be classified according to their digestive fate in the gastrointestinal tract. Starches can be fully digestible in the small intestine (either rapidly digested or slowly digested) or indigestible (resistant). Depending upon food consumption practices and individual gastrointestinal processes, it is possible that some digestible starch may Table 8.1 Known effects of RS on parameters relevant to weight management Resistant to digestion - does not...

Protein and amino acid metabolism

Posttraumatic hypermetabolism is associated with increased catabolism and loss of lean body mass in proportion to the severity of the injury. It is well established that an increased intake of protein is required for wound healing and achievement of nitrogen balance. Patients with sepsis can lose up to 250 g of lean body mass per day if unfed 87 . Muscle proteolysis, a hallmark of protein metabolism in sepsis and trauma, can result in compromised respiratory function and further...

Variations of the Compulsive Personality

Having described the pure compulsive in some detail, we now move on to variations of the basic pattern. The compulsive combines with several other personality disorders, giving a different coloration to the resulting pattern. A brief guide to the subtypes of the compulsive personality is given in Figure 7.1. Actual cases may or may not fall into one of these combinations. FIGURE 7.1 Variants of the Compulsive Personality. FIGURE 7.1 Variants of the Compulsive Personality. More than any other...

Obturator Nerve Entrapment Description

Chronic groin pain is a difficult problem to evaluate. The differential diagnosis for groin symptoms is broad and may include gynecologic, urologic, and colorectal diseases. Moreover, neuropathies of the cutaneous nerves around the hip have been highlighted as etio-logic factors for groin pain.35,37 Nonetheless, the information on this topic is sparse, partly because these injuries are rare. The literature on groin pain of neural origin has mainly focused on the genitofemoral, lateral femoral...

Factors affecting the threshold for excitation

As seen, for example, in Fig. 2.7, excitation of a nerve fibre involves the rapid depolarization of the membrane to a critical level normally about 15 mV less negative than the resting potential. The critical level for excitation is the membrane potential at which the net rate of entry of Na+ ions becomes exactly equal to the net rate of exit of K+ ions plus a small contribution from an entry of Cl- ions. Greater depolarization than this tips the balance in favour of Na+, and the regenerative...

Fermentation Processes

Fermentation is the term used by microbiologists to describe any process for the production of a product by means of the mass culture of a microorganism 1 . The product can either be i The cell itself referred to as biomass production. ii A microorganism's own metabolite referred to as a product from a natural or genetically improved strain. iii A microorganism foreign product referred to as a product from recombinant DNA technology or genetically engineered strain. There are three types of...

Thyroid Follicular Hyperplasia And Neoplasia

Follicular nodules are the most commonly encountered problems in the surgical pathology of the thyroid. These lesions can be classified along the full spectrum of thyroid pathology from hyperplastic nodules to benign follicular adenomas and malignant fol-licular carcinomas. Sporadic nodular goitre is characterised by numerous follicular nodules with heterogeneous architecture and cytology, features that have suggested a hyperplastic rather than neoplastic pathogenesis 7-10 . The gland may be...

The Psychodynamic Perspective

Although the preceding contributions anticipate the modern view, arguably the most important historical development came in 1895 with the publication by Breuer and Freud on unconscious mechanisms in hysteria, stimulated by the famous case of Anna O. Both were fans of hypnosis, used to gain insight into Anna's unconscious conflicts, including her dislike for her father and her love for Breuer, who then left the case to Freud. Eventually, the two formed the theory that hysterical symptoms...

Gender Bias in the Diagnosis of Personality Disorders Do Clinicians Have Gender Expectations

Do certain personality disorders favor men and others favor women The answer may depend on where you look. Because more women than men seek treatment for mental disorders, there are usually more women among the patients in mental health centers. Conversely, because more men than women are veterans, you would expect more male patients at Veterans Administration hospitals. Nevertheless, certain personality disorders do seem weighted toward a particular gender. For some researchers (Kaplan, 1983...

Well Circumscribed Cystic Lesions

The most common clinical differential diagnosis of cystic orbital lesions includes dermoid cyst, colobo-matous cyst, teratoma, meningoencephalocele, lymphangioma, acquired inclusion cyst, chronic hematic cyst (cholesterol granuloma), mucocele, subperiosteal hematoma, and parasitic cyst.25 On MRI these lesions appear as well-defined, round to oval lesions with variable signal intensity depending on the composition of their content (Table 10.4).1,2,5,31 Dermoid cyst may have an homogeneous or...

Vascular Supply To The Femoral Head

Intraarticular isolation of the femoral head and neck makes it highly dependent on its tenuous vascular supply. Its susceptibility to circulatory compromise is an ongoing source of concern to physicians who treat hip pathology. Ischemic insult followed by avascular necrosis AVN of the femoral head, similar to other forms of osteonecrosis, has been clearly linked to certain disease states and types of exposure although it is less clearly associated with others and often purely idiopathic.10 AVN...

Hypointense Seminal Vesicle

Figure 8 Utricle in a 70-year-old man. (A) Axial and (B) coronal T2-weighted images demonstrate a midline, benign utricular cyst of high signal intensity (white arrow). Figure 8 Utricle in a 70-year-old man. (A) Axial and (B) coronal T2-weighted images demonstrate a midline, benign utricular cyst of high signal intensity (white arrow). diagnosed in childhood because of its association with hypospadias, cryptorchidism, and ipsilateral renal agenesis (69-71). Mullerian duct cysts arise from the...

Lateral Uncovering Of The Femoral Head

AP radiograph of the right hip of a 50-year-old woman, demonstrating classic characteristics of acetabular dysplasia. FIGURE 3.28. AP radiograph of the right hip of a 50-year-old woman, demonstrating classic characteristics of acetabular dysplasia. FIGURE 3.29. AP radiograph of the right hip of a 24-year-old woman with mechanical catching, suggestive of labral pathology. Signs of mild dysplasia include a slight valgus position of the femoral neck and slight lateral uncovering of...

The cognitive model of depression and case conceptualization Enduring cognitive vulnerability to depression

Cognitive therapy of depression is defined as 'an active, directive, time-limited, structured approach based on an underlying theoretical rationale that an individual's affect and behaviour are largely determined by the way in which he structures the world'.(1) The cognitive model of depression proposes that enduring cognitive structures and processes shape how everyday experience is interpreted, and are in turn reinforced by these interpretations. This model (illustrated in Fig 1) forms the...

Pitfalls In Image Interpretation

Several problems can be encountered when performing and interpreting CT urograms. Knowledge of these potential pitfalls is important so that studies can be performed with the optimal technique and erroneous interpretations minimized. Figure 13 Tiny bladder cancer. A 3 mm diameter bladder cancer projects into the contrast-containing lumen of the urinary bladder arrow , producing a small filling defect. This could not be seen on any of the 3-D reconstructed images. A variety of criteria must be...

The Fibres That Hold Lens In Position

Function of the lens The lens is one of the essential refractive media of the eye and focuses incident rays of light on the retina. It adds a variable element to the eye's total refractive power (10-20 diopters, depending on individual accommodation) to the fixed refractive power of the cornea (approximately 43 diopters). Shape The fully developed lens is a biconvex, transparent structure. The curvature of the posterior surface, which has a radius of 6 mm, is greater than that of the anterior...

Personality Disorders and Dementia

Perhaps the ultimate overarching task in late life is that of life review looking back over one's life, reflecting on it, and making meaning from the journey. Erik Erikson's (1963) influential developmental theory posited a conflict between ego integrity and despair, with the successful outcome being the achievement of wisdom. As clinicians, we recognize that there can be many hurdles along the way. Wisdom might be a possible outcome, but simply becoming old does not guarantee its achievement....

Spoilage Of Fresh Mushrooms

Quality is the single most important factor affecting retail mushroom sales 21 . Whiteness, cleanliness, and brown blotches on fresh mushrooms are the principal factors determining mushroom quality. Consumers prefer to purchase mushrooms that are bright white, free of casing material or other unwanted particulate contaminants clinging to the mushroom surface, and free of brown blotches. The brown blotch discoloration of mushrooms is perceived as a symptom of decreased freshness or...

Papillary Lesions Of Thyroid

Hyperplastic nodules and adenomas with papillary architecture The papillary hyperplastic nodule of the thyroid is usually identified in girls, usually teenagers in and around the age of menarche. These present as solitary nodules and it is unusual for them to be associated with clinical hyperfunction, although that might occur. These lesion are distinguished from papillary carcinoma in that they are totally encapsulated, often show central cystic change, have subfollicle formation in the...

Structure and Function of Hepatic Sinusoids

The sinusoids are unique exchange vessels composed of specialized nonparenchymal cells that exhibit structural and functional heterogeneity. The structure of the sinusoid is illustrated in Figure 3. The endothelial cells are highly fenestrated and lack a supporting basal lamina. The fenestrae are organized in clusters known as sieve plates. As a result, there is continuity between the plasma in the sinusoid lumen and the perisinu-soidal space (of Disse). The sinusoidal endothelial cells contain...

The Mechanism Of Dna Polymerase

DNA Polymerases Use a Single Active Site to Catalyze DNA Synthesis The synthesis of DNA is catalyzed by an enzyme called DNA polymerase. Unlike most enzymes, which have an active site dedicated to a single reaction, DNA polymerase uses a single active site to catalyze the addition of any of the four deoxynucleosido triphosphates. DNA polymerase accomplishes this catalytic flexibility by exploiting the neatly identical geometry of the A T and G C base pairs remember that the dimensions of the...

Medicare Reimbursement Basics

Reimbursement for chronic hemodialysis and kidney transplantation was scarce until the mid-1960s and haphazard until 1972, when Congress amended the Social Security Act to include coverage for end-stage renal disease for qualified patients. Because the amendment made Medicare the primary kidney transplantation insurer for more than 90 of the United States population, it was Congress and the U.S. Department of Health and Human Services, rather than the commercial health insurance industry, that...

Simulation of Lyophilization Processes

Those sterile dosage forms that are stable only for a short time in solution are frequently marketed in lyophilized presentations (see Figure 3.3). Figure 3.3. Simplified representation of aseptic filling and lyophilization. Figure 3.3. Simplified representation of aseptic filling and lyophilization. The process is more complicated than standard vial filling, although it may involve many items of common equipment. Vials are aseptically filled in the normal way, but the closures (which are of a...

Tendons adnexa and ligaments

Tendons are critical biomechanical units in the musculoskeletal system, the function of which is to transmit the muscular tension to mobile skeletal segments. They are extremely resistant to traction, almost like bone. A tendon with a 10 mm2 transverse section can bear a maximum of 600-1000 kg. On the other hand, tendons are not very elastic, and can only tolerate a maximum elongation of 6 before being damaged. Tendons have very slow metabolism, even during action. This can be significantly...

Antiparkinsonian Therapy And Hypersexuality

With the advent of antiparkinsonian therapy, reports of increased libido and sexual performance, hypersexual behavior (with or without concomitant hypomania), and rarely paraphilias have appeared in the literature.11-25 Comparisons cannot be made among studies, as different criteria were used to collect data. Due to the small size of the studies, the incidence of increased sexual drive in patients receiving treatment with antiparkinsonian therapy cannot be determined. The data does not provide...

Blunt Ocular Trauma Ocular Contusion

Epidemiology and etiology Ocular contusions resulting from blunt trauma such as a fist, ball, champagne cork, stone, falling on the eye, or a cow's horn are very common. Significant deformation of the globe can result where the diameter of the blunt object is less than that of the bony structures of the orbit. Clinical picture and diagnostic considerations Deformation exerts significant traction on intraocular structures and can cause them to tear. Often there will be blood in the anterior...

Nutritional Factors that Influence Microbial Growth

Growth of any bacterium depends not only on a suitable physical environment, but also an available source of chemicals to use as nutrients. From these, the cell must synthesize all of the cell components discussed in chapter 3, including lipid membranes, cell walls, proteins, and nucleic acids. These components are made from building blocks such as fatty acids, sugars, amino Table 4.3 Representative Functions of the Major Elements Component of cellular constituents including amino acids,...

Microscopic Techniques Dyes and Staining

It can be difficult with the bright-field microscope to observe living microorganisms. Most are nearly transparent and often move rapidly about the slide. Consequently, cells are frequently immobilized and stained with dyes. These dyes may be attracted to one or more cellular components. As a result, an entire organism, or its specific parts, can be made to contrast with the unstained background. Many different dyes and staining procedures can be used each has specific applications table 3.2 ....

The Discouraged Borderline

The discouraged borderline is mixed with the dependent or avoidant patterns. Such individuals pursue a strategy of submissive attachment to just one or two significant others. FIGURE 14.1 Variants of the Borderline Personality. FIGURE 14.1 Variants of the Borderline Personality. Prominent personality traits include not only avoidance of competition, loyalty, and humility but also masochistic subordination and a parasitic clinginess. By exclusively relying on a single someone, discouraged...

Alpf Medical Research Personality Disorders

Although the term masochistic was coined in reference to a specific male sexual perversion, it quickly became associated with the feminine and submissive. Hence, it has become a politically charged construct that has been dropped from the DSM-IV. The masochistic personality also has several normal variants that are often described as saintly. For example, Oldham and Morris's (1995) self-sacrificing style lives to serve others. Millon's yielding style is moving closer toward the pathological end...

Analysis of regions of the 5 and 3 UTRs involved in DENV translation and RNA synthesis

Viral translation and RNA synthesis of positive-sense RNA viruses is often regulated by the 5' and 3' UTRs. Previously, we had demonstrated a role for the DENV-2 terminal 3'SL in stimulating viral translation via deletion analysis in RNA reporter constructs (Holden & Harris 2004). To examine other regions of the DENV-2 UTRs, we targeted conserved domains in the 5' and 3' UTRs by complementary peptide-conjugated phosphorodiamidate morpholino oligomers (P-PMOs), as depicted in Fig. 3. The...

Meiosis In Grasshopper Testis

For each pair of terms, explain how the meanings of the terms differ. 2. Explain the relationship between the terms chromosome and homologous chromosomes. 3. Use the following terms in the same sentence mitosis, meiosis, and cytokinesis. 4. Word Roots and Origins The word oogenesis is derived from the Greek oion, which means egg, and geneia, which means birth. Using this information, explain why the term oogenesis is a good name for the biological process it describes. 5. Describe the...

Skin Diseases Caused by Fungi

Diseases caused by fungi are called mycoses. Earlier in this chapter, we mentioned the role of normal flora yeast of the genus Malassezia in causing mild skin diseases, such as tinea versicolor. Other fungi are responsible for more serious infections of the skin, although even in these cases the condition of the host's defenses against infection is often crucial. The yeast Candida albicans (figure 22.26) may live harmlessly among the normal flora of the skin, but in some people it invades the...

Chylomicron metabolism the exogenous pathway

The metabolism of chylomicrons is often called the exogenous pathway of lipoprotein metabolism. Exogenous means 'from outside the body', since this is the pathway for transporting fat from outside the body - in fact, fat which has been eaten. The pathway is summarised in Fig. 9.2. We have already seen how triacylglycerol and cholesterol are absorbed and re-esterified in the cells of the intestinal wall, and secreted as chylomicron particles, via the lymphatics, into the circulation Section...

Sulfonylurea Sensitivity and MODY

MODY is a relatively rare form of familial diabetes and is part of the differential diagnosis of diabetes presenting in the first three decades of life. MODY is now known to differ fundamentally from type 2 DM in its etiology and is classified separately as type 3A. The key characteristics of this condition are an young age of onset (often before the age of 25 years), noninsulin dependence (absence of features of type 1 DM, with C-peptide positiv-ity and no requirement for insulin within five...

The period of adaptation to starvation

The changes listed in Table 8.2 come into place gradually over the first three weeks or so of total starvation this is the period of adaptation. Blood glucose concentrations fall very gradually in prolonged starvation and they are followed by the plasma insulin concentration. Glucagon concentrations, on the other hand, rise, so that the ratio of insulin glucagon reaching the liver must change considerably from early to late starvation. The plasma leptin concentration also falls. In longer...

Importance Of Structure And Function

An ideal reconstruction of the oral cavity is one that very closely resembles the original structures in both form and function. To approach this ideal, the interactions between structures both within and beyond the oral cavity must be considered Fig. 1 . Furthermore, advanced reconstructive techniques typically require utilizing or transversing structures adjacent to the oral cavity. Thus, a detailed understanding of both the structures within the oral cavity, and those related to it, is...

Lactic Acid and Insulin

As mentioned, under hypoxic conditions lactic acid may stimulate production of angiogenic factors by macrophages. Unfortunately, few natural compounds have been tested for their effects on lactic acid generation in cancer cells. In one study, apigenin and luteolin inhibited both proliferation and lactic acid release from a human adenocarcinoma cell line in vitro.127 In other studies, the flavonoid quercetin reduced the production of lactic acid in healthy rat cells, probably by blocking the...

Contraindications and false contraindications

Contraindications to immunization dictate circumstances when vaccines should not be given because the condition in an individual increases the risk for a serious adverse reaction following immunization. The majority of con traindications are temporary, and the vaccine can be given later. However, in many cases immunization is delayed or denied because of conditions falsely believed by the physician or the health worker to constitute a contraindication. The World Health Organization and the...

International Personality Disorder Examination

The International Personality Disorder Examination (IPDE Loranger, 1999) is an extensive-semi-structured diagnostic interview to evaluate personality disorders according to both the DSM-IV and International Classification of Diseases, 10th edition (ICD-10) classification systems. Impetus for the creation of the IPDE came from the World Health Organization and the U.S. Alcohol, Drug Abuse, and Mental Health Administration in their joint effort aimed at producing a standardized assessment...

Vaccines and Immunization Procedures

A vaccine is a preparation of a disease-causing agent or its products used to induce active immunity. Vaccines not only protect an individual against disease, they can also prevent diseases from spreading in a population. When a critical portion of a population is immune to a disease, either through natural immunity or vaccination, a phenomenon called herd immunity develops. 17.2 Vaccines and Immunization Procedures 421 This is the inability of an infectious disease to spread because of the...

Microbiology of Sewage Treatment

Sewage, or wastewater, is composed of all the material that flows from household plumbing systems, including washing and bathing water and toilet wastes. Municipal wastewater also includes industrial wastes. In many cities, storm water runoff that flows into street drains enters the sewage system as well. The most obvious reason that sewage must be treated before discharge is that pathogenic microbes can be transmitted in feces, including those that cause diarrheal diseases and hepatitis. If...

Normal Flora of the Skin

The skin represents a distinct ecological habitat, analogous to a cool desert, compared to the warm, moist tropical conditions that exist in other body systems. Large numbers of microorganisms live on and in the various components of the normal skin. For example, depending on the body location and amount of skin moisture, the number of bacteria on the skin surface may range from only about 1,000 organisms per square centimeter on the back to more than 10 million in the groin and armpit, where...

History and Development of Antimicrobial Drugs

To appreciate the unique antibiotic era in which we now live, it is helpful to understand the history and development of these life-saving remedies. The development of Salvarsan by Paul Ehrlich was the first documented example of a chemical used successfully as an antimicrobial medication. The next breakthrough in the developing science of antimicrobial chemotherapy came almost 25 years 508 Chapter 21 Antimicrobial Medications 508 Chapter 21 Antimicrobial Medications Table 21.1 Terms that...

Equipment and Scaleup

The availability of hardware at the required scale, or the complexity of its deployment, may influence which techniques are used and how they are implemented. Large-scale engineering, for example of flow distributors, can be a critical issue. The difficulties of large-scale operation can be balanced against the cost of running multiple cycles at a Figure 18.3 Pilot-scale columns used in Phase II clinical manufacture. A 30-litre size exclusion column and a 2-litre ion exchange column used for...

Lateral Epicondylitis and Lateral Collateral Ligament Injury

Lateral epicondylitis, also called tennis elbow, is caused by degeneration and tearing of the common extensor ten-don.22 This condition often occurs as a result of repetitive sports-related trauma to the tendon, although it is seen far more commonly in nonathletes.9 In the typical patient, the degenerated extensor carpi radialis brevis tendon is partially avulsed from the lateral epicondyle.22 Scar tissue FIGURE 4.4. Clinically suspected tennis elbow in a patient who did not respond to a local...

Variations of the Narcissistic Personality

Few individuals in real life exist as the incarnation of an abstract psychological ideal. Instead, most persons combine aspects of two or more personality styles, though some combinations are more common than others. Whereas the previous section sharpened the contrast between various prototypes for explanatory purposes, in this section we portray narcissistic variants that are found as the disorder begins to shade toward other personalities (see Figure 10.2 for a summary). Actual cases may or...

The Log Cell Kill Hypothesis

Cytotoxic drugs act by first-order kinetics that is, at a given dose, they kill a constant fraction of the tumor cells rather than a fixed number of cells. For example, a drug dose that would result in a three-log cell kill (i.e., 99.9 cytotoxicity) would reduce the tumor burden of an animal that has 108 leukemic cells to 105 cells. This killing of a fraction of cells rather than an absolute number per dose is called the log cell kill hypothesis. The earliest detectable human cancers usually...

Variable Loop In Trna Role

FIGURE 14-3 A subset of modifief nucleosides found in tRNA. plays an important role in the process ofcedon recognition by certain tRNAs. tRNAs Share a Common Secondary Structure that Resembles a Clover leaf As we saw in Chapter 6, RNA molecules typically contain regions of self-complementarity that enable them to form limited stretches of double helix that are held together by base pairing. Other regions of RNA molecules have no complement and hence, are single-stranded. tRNA molecules exhibit...

The Depressive Personality

Almost imperceptibly at first, then more and more, you begin to feel sad, empty, or irritable. Gradually, things that used to fascinate you are no longer interesting. Hobbies, favorite recreations, and spending time with the ones you love are no longer pleasurable and may even seem burdensome. The day becomes dominated by feelings of lethargy, being tired, run down, or overwhelmed by life. Your movements and mental processes may seem to move in slow motion, thoughts crawling like molasses....

Variations of the Dependent Personality

In addition to the more prototypal cases described in this chapter, there are several variations of the dependent that express its combination with other personalities. Figure 8.1 provides a summary of these subtypes. Actual cases may or may not fall into one of these combinations. A mixture of both the dependent and avoidant patterns, the disquieted dependent is often found in an extreme form in institutional settings that minister to chronic ambulatory patients. Most live a parasitic...

Hyperopia Farsightedness Definition

In hyperopia, there is a discrepancy between the refractive power and axial length of the eye such that parallel incident light rays converge at a focal point posterior to the retina (Fig. 16.10a). Epidemiology Approximately 20 of persons between the ages of 20 and 30 have refraction exceeding +1 diopters. Most newborns exhibit slight hyperLang, Ophthalmology 2000 Thieme All rights reserved. Usage subject to terms and conditions of license. Fig. 16.10 a The focal point of parallel light rays...

Mastoidectomy Facial Recess Approach and Cochleostomy Techniques

The important point in considering the mastoidect-omy for placement of a cochlear implant is that this is much smaller than that utilized for chronic ear disease. In contrast to the standard method of saucerizing the mastoid cavity, this is not performed in cochlear implant surgery. There are two areas that need to be skeletonized, and the single most important one of these is the bony external auditory canal. If the bony external auditory canal is not thinned appropriately, then the angle...

Sadistic Personality Disorder Dsmiiir Appendix A

People with Sadistic Personality Disorder are pervasively cruel, demeaning, and verbally and physically aggressive in most of their relationships. The sadistic behavior is typically more evident when the sadistic individual is in a position of power, as in the role of a father, mother, or uncle, or in occupational settings as a boss or in any position where there are subordinates. In contrast, individuals with Sadistic Personality Disorder often manage to contain their behavior when they are in...

Variations of the Schizotypal Personality

The evolutionary model (Millon, 1990) holds that the schizoid and avoidant shade gently into the schizotypal thus, these personalities naturally form structural subtypes for this pattern (see Figure 12.1). Actual cases may or may not fall into one of these combinations. The insipid schizotypals represent a structural exaggeration of the passive-detached pattern. Like the schizoid, they are notably insensitive to feelings, seem indifferent to the external world, and appear drab, unmotivated,...

The Biological Perspective

The history of the schizoid personality begins in early descriptive psychiatry and continues through later temperament and constitutional theorists. Early writers emphasized different characteristics of the modern prototype. For example, Ribot (1890) invented the term anhedonia to describe the diminished ability to experience pleasure, characteristic of the schizoid pattern. Similarly, A. Hoch (1910) described what he called the shut-in personality, using adjectives such as reticent, seclusive,...

Viruses Are the Ultimate Parasites

Virus-caused diseases are numerous and all too familiar chicken pox, influenza, some types of pneumonia, polio, measles, rabies, hepatitis, the common cold, and many others. Smallpox, once a worldwide scourge, was eradicated by a decade-long global immunization effort beginning in the mid-1960s. Viral infections in plants (e.g., dwarf mosaic virus in corn) have a major economic impact on crop production. Planting of virus-resistant varieties, developed by traditional breeding methods and more...

Metabolic Effects of Cytokines in Burns Trauma and Sepsis

TNF Primary mediator in inflammatory response, increase in acute phase proteins, reduction in skeletal muscle and diaphragm contractility IL-1 Activation of T cells, iNOS expression, prostaglandin production, inhibition of lipoprotein lipase, procoagulant activity, increase in acute phase proteins IL-6 Key later role in inflammatory cascade, activation of lymphocytes, increase in acute phase proteins, endogenous pyrogen IL-8 Key later role in inflammatory cascade, regulates neutrophil activity...

Variations of the Histrionic Personality

The norm is to receive more than one personality disorder diagnosis. Combinations with secondary patterns lead to colorations of the primary pattern, though occasionally subtypes appear merely as a combination of the major traits. Frequently seen subtypes of the histrionic personality are described in the following sections and summarized in Figure 9.1. Actual cases may or may not fall into one of these combinations. FIGURE 9.1 Variants of the Histrionic Personality. FIGURE 9.1 Variants of the...

Schneiderian Papilloma Exophytic

Fig. 1.29 Inverted papilloma A Low magnification showing hyperplastic aggregates of well-demarcated squamous and respiratory epithelium extending throughout the stroma. Note the absence of mucoserous glands. B Papilloma composed partially of hyperplastic, ciliated respiratory epithelium. Note the epithelial transmigration of neutrophils and the delicate basement membrane. C HPV nuclear and cytoplasmic reactivity can be seen in some inverted papillomas, usually in the same nuclei which exhibit...

Congenital Ocular Melanocytosis

Ocular melanocytosis. a Heterochromia with light brown right iris and dark brown left iris. b Episcleral melanocytosis Fig. 8.11 a, b. Ocular melanocytosis. a Heterochromia with light brown right iris and dark brown left iris. b Episcleral melanocytosis Although it is not strictly in the conjunctiva, congenital ocular melanocytosis is included here because it is an important epibulbar lesion of childhood. It is a congenital diffuse, patchy epibulbar pigmentation that is situated...

Carl G Jung Jungs Contribution to Personality Theory

Although Jung is among the seminal thinkers in personality, his contributions have rarely been applied in the personality disorders. Once Freud's primary disciple, Jung broke from Freud, insisting that there is more to mental life than sex. Most students are acquainted with his distinction between extroversion and introversion. Extroverts explain events from the viewpoint of the environment. They see the focus of life as being driven by events outside themselves and fix their attention firmly...

Parasitic Retinal Disorders Definition

Inflammation of the retina caused by infection with parasites such as Onchocerca volvulus (the pathogen that causes onchocerciasis), Toxocara canis or Toxocara cati (nematode larvae that are normally intestinal parasites of dogs and cats), Taenia solium, (pork tapeworm), and other parasites. Epidemiology Onchocerciasis, like trachoma and leprosy, is one of the most frequent causes of blindness worldwide. However, like the other parasitic diseases discussed here, it is rare in Europe and North...

Persistent Hyperplastic Primary Vitreous PHPV Definition

Persistence of the embryonic primary vitreous (hyaloid arterial system including the posterior tunica vasculosa lentis). Epidemiology This developmental anomaly is also very rare. Symptoms and findings Usually the disorder is unilateral. Anterior variant of PHPV. With this more frequent variant, a white pupil (leukocoria or amaurotic cat's eye) typically will be discovered shortly after birth. This is caused by the whitish plate of connective tissue posterior to the lens. Depending on the...

Molecular Tumbling And Nmr Relaxation

What is the mechanism of spins dropping down from the ft state to the a state and fanning out around the two cones, and what determines the rates (R1 1 T1 and R2 1 T2)ofNMR relaxation These processes are intimately tied to the motion of molecules as they tumble (reorient) in solution in their rapid Brownian motion, and measurement of the NMR relaxation parameters T1 and T2 can even give us detailed information about molecular dynamics (motion) from the point of view of each spin in the...

Culturing Hippocampal and Cortical Neurons

Miller Department of Biology University of North Dakota Grand Forks, North Dakota 58202 II. Acquisition of Hippocampal and Cortical Neurons B. Cell Dissociation and Storage III. Short-Term Culture Methods B. Long-Term Maintenance of Neurons Using Glia-Conditioned Medium C. Culture Characteristics V. Summary Primary cultures of rat and mouse hippocampus and cerebral cortex are widely used to study neuronal properties such as axonal extension, synaptic transmission,...

Capsular and joint architecture

The ilium, ischium, and pubic bones unite at the acetabulum, forming the innominate bone. During childhood, these bones are separated within the ac-etabulum by the triradiate cartilage, which fuses at skeletal maturity. The acetabulum has an inclined abduction angle of approximately 35 degrees from the horizontal and a forward flexed position of approximately 20 degrees Figure 6.8A,C . The articular surface of the acetabulum has a horseshoe or lunate shape Figure 6.9 . The central inferior...

Noninfectious Conjunctivitis

Table 4.4 provides an overview of pathogens, symptoms, and treatments of noninfectious conjunctivitis. Acute conjunctivitis is frequently attributable to a series of external irritants or to dry eyes conjunctivitis sicca . The disorder is unpleasant but benign. Primary symptoms include foreign-body sensation, reddening of the eyes of varying severity, and epiphora. Therapy should focus on eliminating the primary irritant and treating the symptoms. Acute conjunctivitis should be distinguished...

The impact of genetic engineering on vaccine technology

The advent of recombinant DNA technology has rendered possible the large-scale production of polypeptides normally present on the surface of virtually any pathogen. These polypeptides, when purified from the producer organism (e.g. E. coli, Saccharomyces cerevisiae) can then be used as 'subunit' vaccines. This method of vaccine production exhibits several advantages over conventional vaccine production methodologies. These include Production of a clinically safe product the pathogen-derived...

Examination of the Conjunctiva

The conjunctiva is examined by direct inspection. The bulbar conjunctiva is directly visible between the eyelids the palpebral conjunctiva can only be examined by everting the upper or lower eyelid. The normal conjunctiva is smooth, shiny, and moist. The examiner should be alert to any reddening, secretion, thickening, scars, or foreign bodies. Eversion of the lower eyelid. The patient looks up while the examiner pulls the eyelid downward close to the anterior margin (Fig. 1.7). This exposes...

The EPOR modela human sexual response cycle model

The most successful model was that formulated by Masters and Johnson. 20 In the laboratory, they observed the changes that took place in the male and female body and especially the genitals during sexual arousal to orgasm either by masturbation or by natural or artificial coitus with a plastic penis that allowed internal filming of the female genitalia. After studying approximately 7500 female and 2500 male arousals to orgasm in some 382 female and 312 male volunteers over 11 years they...

Retrochiasmal Lesions

Etiology Retrochiasmal lesions may result from a wide variety of neurologic disorders such as tumors, vascular insults, basal meningitis, aneurysms of the posterior communicating artery, abscesses, injuries (such as a contrecoup injury to the occipital lobe), and vasospasms (in an ocular migraine). Symptoms, diagnostic considerations, and clinical picture Visual field testing in particular will provide information on the location of the lesion. Perimetry is therefore a crucial diagnostic study....

Antisocial Personality Disorder

As the term antisocial implies, individuals with this disorder are against society. Indeed, the hallmark feature is a pervasive pattern of disregard for, and failure to comply with, societal norms. Among people with Antisocial Personality Disorder, the rights of others are never a consideration, and when individuals with this disorder hurt, deceive, manipulate, abuse, or victimize others, they fail to experience remorse, guilt, or shame. When caught, antisocial types may weep crocodile tears...

CPAP and intracranial pressure regulation

Some concern may arise when CPAP is delivered to patients with increased intracranial pressure. Positive intrathoracic pressure may indeed decrease venous return and act as a resistive component to venous return from the head, thus increasing intracranial venous pressure and eventually parenchymal intracranial pressure. Decreased systemic venous return may also decrease cardiac output and blood pressure which will decrease oxygen delivery and perfusion to the already jeopardized cerebral...

Focal Thickening Of Postero Lateral Bladder Wall

Figure 10 Caliceal diverticulum. (A) Excretory-phase axial image demonstrates a urine-contrast level in a mass in the upper pole of the right kidney (arrow). This mass had uniform water attenuation on the precontrast images. Based upon these findings, a diagnosis of caliceal diverticulum can be made. (B) This large caliceal diverticulum is also easily seen on the coronal volume-rendered 3-D reconstruction (arrow). Bladder cancers may also produce small mural nodules. These can be detected by...

Non Venereal Genital System Diseases

The genital tract is the portal of entry for numerous infectious diseases, both venereal and non-venereal (venereal, from Venus, the goddess of love non-venereal means not transmitted by making love). This section discusses some examples of non-venereal genital diseases. The term venereal disease (VD), formerly meaning disease transmitted almost exclusively by sexual intercourse, is now often used interchangeably with sexually transmitted disease (STD), which includes all diseases spread by...

Variations of the Paranoid Personality

Although the paranoid personality is a tightly knit syndrome, its features nevertheless combine with those of several other personalities, producing variations of the core prototype, described in the following paragraphs and summarized in Figure 13.1. Actual cases may or may not fall into one of these combinations. FIGURE 13.1 Variants of the Paranoid Personality. FIGURE 13.1 Variants of the Paranoid Personality. The fanatic paranoid pattern often resembles its less troubled cousin, the...

Horneys Description of Types

Compliant Type (Moving toward People) Compliant types have a strong and compulsive need for affection, approval, belonging, and human intimacy. They need a partner on whom they can regularly rely for help, protection, and guidance. Their urge to satisfy these compulsions is so strong that they often forget what their own real feelings are because they become so sensitive to their partner's feelings. They become so unselfish and self-sacrificing that they have a warped view of their own needs...

Inadequate Personality Disorder

The Inadequate Personality Disorder description in DSM-II included ineffectual responses to any physical, intellectual, social, or emotional demands placed on the individual. Despite the lack of any real physical or intellectual deficits, these patients appear poorly adapted to their environment, are inept, have poor judgment, are socially unstable, lack physical and emotional stamina, and chronically cannot cope with everyday stress and strain. Detailed, behaviorally specific criteria were not...

A new look at levodopa based on the Elldopa study

Department of Neurology, Columbia University, New York, NY, USA Summary. Levodopa has been the gold standard for Parkinson's disease (PD) therapy since it was successfully introduced in 1967. But in the years since then, after recognizing that levodopa often leads to the motor complications of wearing-off and dyskinesias, there have been debates among clinicians as to when levodopa therapy should be started. Delaying therapy was advocated for the purpose of delaying the development of these...

Signs and Symptoms of Hypoventilation

The presence of clinical symptoms and or physiologic markers of hypoventilation are useful in identifying clinical severity as it relates to therapeutic decision-making with regard to initiation of nocturnal NIPPV. In the course of a typical progressive disease, two successive steps occur more or less rapidly (i) nocturnal hypoventilation reversible during wake associated with none or a few clinical symptoms and (ii) nocturnal and daylight hypoventilation associated with clinical symptoms,...

Formulation of insulin products

Insulin, whatever its source, may be formulated in a number of ways, generally in order to alter its pharmacokinetic profile. Fast (short)-acting insulins are those preparations that yield an elevated blood insulin concentration relatively quickly after their administration (which is usually by s.c. or, less commonly, by i.m. injection). Slow-acting insulins, on the other hand, enter the circulation Table 11.3 Native and engineered human insulin preparations that have gained approval for...

The Interpersonal Perspective

The interpersonal perspective is concerned with how human beings interact and how these interactions support, invalidate, and elaborate the self-image. Sullivan is considered the father of this approach, reacting against the classical psychoanalysis of Freud, whereby pathology was always a property of the person. Instead, Sullivan saw psychopathology as emerging from an individual's relationships and patterns of communication. According to Sullivan (1956, p. 145), there are two requirements for...

Direct Vs Indirect Molecular Diagnostic Tests

Genetic testing, through interrogation of DNA, RNA, chromosomes, or proteins, can provide critical information for the detection of heritable disease genotypes for a number of different applications Table 3 15 . Many procedures can be used in either a direct or indirect mutation analysis. Most types Applications of Molecular Genetic Testing Diagnostic testing Testing for a gene mutation in symptomatic individuals as a diagnostic aid. Newborn screening Testing is used to screen populations to...

Nutrition and the metabolic response to injury

Cuthbertson described the metabolic response to injury as consisting of an ebb phase and a flow phase.2526 The ebb phase is the period of traumatic shock or hypometabolism during the first few hours or days after injury. This phase is soon replaced by the flow phase that is a period of hypermetabolism that may last for weeks or months depending on the nature of the injury and obstacles to recovery. In the case of minor injury, such as elective surgery, both of these phases may be relatively...

Testicle Shrinkage Treatment

Feel your breast in overlapping areas. Some research suggests that many women do breast self-examinations more thoroughhly when they use a pattern of up-and-down lines or strips. Other women feel more comfortable with another pattern. The important thing is to cover the entire breast and to pay special attention to the area between the breast and the underarm, including the underarm itself. Check the area above the breast, up to the collarbone and all the way over to your shoulder. Feel the...

The DSM Multiaxial Model

The disorders in the DSM are grouped in terms of a multiaxial model. Multiaxial literally means multiple axes. Each axis represents a different kind or source of information. Later, we concentrate on exactly what these sources are now, we just explain their purpose. The multiaxial model exists because some means is required whereby the various symptoms and personality characteristics of a given patient can be brought together to paint a picture that reflects the functioning of the whole person....

Paranasal Sinuses Sinusitis

Anatomical (compromised patency of ostia causes hypooxygenation and impairment of sinus drainage) Dysfunction of Cilia Motility Change in Quality of Secretions Viral rhinovirus (most common) Bacterial S. pneumoniae (most common bacterial agent), H. influenzae, B. catarrhalis, S. aureus, S. pyogenes Fulminant Fungal Aspergillosis, Phaehyphomycosis, Mucor, Rhizopus Chronic anaerobes, S. aureus, H. influenzae, 1 2 fungal Complicated Sinusitis Cystic Fibrosis P. aeruginosa, S. aureus Nosocomial P....

Vitreous Hemorrhage Definition

Bleeding into the vitreous chamber or a space created by vitreous detachment. Epidemiology The annual incidence of this disorder is seven cases per 100000. Etiology A vitreous hemorrhage may involve one of three possible pathogenetic mechanisms (Fig. 11.5) 1. Bleeding from normal retinal vessels as can occur as a result of mechanical vascular damage in acute vitreous detachment or retinal tear. 2. Bleeding from retinal vessels with abnormal changes as can occur as a result of retinal...

Occasional Plasmids are Linear or Made of RNA

Although most plasmids are circular molecules of DNA there are occasional exceptions. Linear plasmids of double-stranded DNA have been found in a variety of bacteria and in fungi and higher plants. The best-characterized linear plasmids are found in those few bacteria such as Borrelia and Streptomyces that also contain linear chromosomes (see Ch. 5). Linear DNA replicons in bacteria are not protected by incompatibility The inability of two plasmids of the same family to co-exist in the same...