Thoracoscopic upper thoracic sympathectomy for primary palmar hyperhidrosis--the combined paediatric, adolescents and adult experience

OBJECTIVE: To present our experience, over the past 4 years, of thoracoscopic upper thoracic sympathectomy in patients with primary palmar hyperhidrosis. DESIGN: Retrospective study. SETTING: University hospital, Israel. SUBJECTS: 402 thoracoscopic upper thoracic sympathectomies in 223 patients over a period of 4 years. INTERVENTIONS: Thoracoscopic ablation of ganglia and severing of the sympathetic chain at the level of T2 and T3. 142 patients underwent bilateral simultaneous sympathectomy, 37 had bilateral non-simultaneous sympathectomy and 44 had unilateral sympathectomy. RESULTS: 220 patients (98.7%) had an uneventful postoperative course and were discharged the following day. Three patients with residual pneumothorax required intercostal drainage and were discharged on the third postoperative day. 219 patients (98.2%) were completely satisfied, having immediate and permanent relief of palmar sweating. Four patients were dissatisfied. CONCLUSION: The thoracoscopic approach to the upper thoracic sympathectomy is at present the procedure of choice. Early operation for severe palmar hyperhidrosis is indicated to save a child many years of frustration and discomfort.     

Deep dyslexia and the right hemisphere hypothesis: Evidence from the U.S.A. and the U.S.S.R.

Discusses the theory that asserts that the residual reading abilities seen in deep dyslexia entirely reflect the operation of an intact right hemisphere reading system rather than a partially disabled left hemisphere reading system. Evidence from an experiment with normal Ss in a report by the present author and colleagues (1983) is presented, which suggests that the right hemisphere contains no lexical entries for abbreviations that can be accessed by visual presentation. Data are presented from studies by K. E. Patterson (1980; see also PA, Vols 63:12203 and 64:10691) on 2 male deep dyslexic's understanding of printed abbreviations, along with observations of a young female deep dyslexic who was tested on understanding of abbreviations and on letter-naming abilities. Considerable sparing of the ability to obtain semantic information from printed abbreviations was evidenced in all 3 Ss. This contrast suggests that the current right hemisphere account of the residual reading abilities seen in deep dyslexia is not a sufficient one and should be modified. (French abstract) (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physician migration to the U.S.--foreign aid for U.S. manpower

Data were obtained from the American Medical Association on Iranian physicians practicing in the U.S., and from the Iranian Medical Registry on U.S.-trained Iranian physicians who have returned to practice in Iran. There were 2,066 Iranian physicians practicing in the U.S. in 1972, 1,234 (60%) of whom were not undergoing any training. Only 600 of Iran's 9,535 physicians in 1972 had been trained in the United States. Thus, less than one-third of the specialists who have completed training in the U.S. have returned to practice in Iran. The specialist group with the highest rate of return is the combined surgery subspecialties (neurosurgery, thoracic surgery, orthopedic surgery, and plastic surgery). The specialist groups with the lowest rates of return were pathology, anesthesiology, and psychiatry. A comparison is made of the manpower problems Iran faces and the American problems in the area of physician manpower.     

Safety and efficacy of intravenous sodium stibogluconate in the treatment of leishmaniasis: recent U.S. military experience

The efficacy and toxicity of sodium stibogluconate (SSG) at a dosage of 20 mg/(kg.d) for either 20 days (for cutaneous disease) or 28 days (for visceral, mucosal, or viscerotropic disease) in the treatment of leishmaniasis is reported. Ninety-six U.S. Department of Defense health care beneficiaries with parasitologically confirmed leishmaniasis were prospectively followed for 1 year. One patient was infected with human immunodeficiency virus; otherwise, comorbidity was absent. Clinical cure occurred in 91% of 83 cases of cutaneous disease and 93% of 13 cases of visceral/viscerotropic disease. Adverse effects were common and necessitated interruption of treatment in 28% of cases, but they were generally reversible. These included arthralgias and myalgias (58%), pancreatitis (97%), transaminitis (67%), headache (22%), hematologic suppression (44%), and rash (9%). No subsequent mucosal leishmaniasis was identified, and there were no deaths attributable to SSG or leishmaniasis.     

中美在城市水源地供水过程中生态补偿的差异性

饮用水源保护是确保饮用水安全的重要保障.为了深入探讨不同国家生态补偿的经验教训,以城市供水系统为案例,分析美国纽约州与中国北京密云水库在城市供水过程中生态服务付费的差异性.结果表明:虽然美国和中国之间的生态补偿制度具有一定的独特性,但美国在市郊水库为纽约市政供水过程中的补偿效应值得中国借鉴.中国的生态补偿中的关键步骤必须包括生态效益评价的数量化和货币化.此外,现有研究结果认为,美国在公众参与生态补偿全过程的做法值得中国效法,而中国的退耕还林工程的生态效率和效益值得美国借鉴.     

Smearing the opposition: Implicit and explicit stigmatization of the 2008 U.S. Presidential candidates and the current U.S. President.

Four studies investigated whether political allegiance and salience of outgroup membership contribute to the phenomenon of acceptance of false, stigmatizing information (smears) about political candidates. Studies 1–3 were conducted in the month prior to the 2008 U.S. Presidential election and together demonstrated that pre-standing opposition to John McCain or Barack Obama, as well as the situational salience of differentiating social categories (i.e., for Obama, race; for McCain, age), contributed to the implicit activation and explicit endorsement of smearing labels (i.e., Obama is Muslim; McCain is senile). The influence of salient differentiating categories on smear acceptance was particularly pronounced among politically undecided individuals. Study 4 clarified that social category differences heighten smear acceptance, even if the salient category is semantically unrelated to the smearing label, showing that, approximately 1 year after the election, the salience of race amplified belief that Obama is a socialist among undecided people and McCain supporters. Taken together, these findings suggest that, at both implicit and explicit cognitive levels, social category differences and political allegiance contribute to acceptance of smears against political candidates. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

African-American dentists in the U.S. Army: the origins

The majority of the dentists mentioned in this work are unknown both to dental and military historians. However, the contributions of Dr. William T. Jefferson, the first African-American dentist to treat U.S. Army soldiers in Cuba, Dr. William A. Birch, the first black hospital steward/dentist to serve unofficially (as a dentist) overseas in the Philippine campaign, and the dental veterans of 1917-1918, deserve recognition. They were among the early pioneers in the U.S. Army's dental history.     

Ideals in action: the U.S. Schweitzer Fellows Programs

This paper is a brief report of the symposium, "Improving the Evidence Base for Anaesthesia and Intensive Care", organized by the MASTER Anaesthesia Trial Study Group at the Annual Scientific Meeting of the Australian and New Zealand College of Anaesthetists, Newcastle, N.S.W., on Tuesday, May 5, 1998.     

Increasing diversity of the U.S. population

Demographic changes have shaped the nation's past and will continue to shape its future. During the first half of the 1990s, the U.S. population grew, on average, by 2.7 million people each year, reaching 262.8 million in 1995. Population growth is projected to continue for the next 50 years, although at a slower rate. The forecast is for more than 390 million Americans by the year 2050. As the U.S. population grows, it will increasingly become more diverse along many socioeconomic dimensions. This increasing diversity will represent an historic shift in America's racial and ethnic composition with long-range implications for how we view racial issues, how we define racial categories and how the political landscape will be refashioned. By the middle of the 21st century the "minority" population will almost equal the size of the non-Hispanic white population. The minority population grew 14 percent during the first half of the 1990s compared with a 3 percent growth in the non-Hispanic white population. But even within the minority population, growth rates varied. Between 1990 and 1995, the Asian population grew 23 percent, the Hispanic population 20 percent and the African American population increased their numbers by 8 percent. Hispanics are projected to outnumber African Americans within the next 15 years. In part, these demographic changes are shifting because of U.S. immigration policies. Until the early 1960s, immigrants to the United States were primarily of white, European stock. Nowadays, Europeans account for about 20 percent of the immigrants. Three-quarters of legal immigrants in the mid-1990s now come from Latin America, the Caribbean and Asia. The increasing racial and ethnic diversity in the United States will create both challenges and opportunities for U.S. schools and businesses in the future. The magnitude of these numbers and their geographic location will be important factors to consider as we prepare for the 21st century.     

2000年美国钨市概览

仲钨酸铵/氧化物/碳化钨粉/矿石和精矿/其他/钨铁/钨粉/废料和废金属/图1 2000年美国进口的钨材料     

Thoracoscopic harvest of the internal thoracic artery: a multicenter experience in 218 cases

BACKGROUND: Off-pump bypass grafting most commonly involves harvest of the left internal thoracic artery (ITA) through a minithoracotomy under direct vision. Disadvantages to this approach, however, include poor exposure, incomplete dissection resulting in inadequate ITA length, and significant postoperative pain because of rigorous chest retraction. This study determined the safety and efficacy of an alternative to direct ITA harvest using a thoracoscopic approach. METHODS: Two hundred eighteen patients at three institutions underwent thoracoscopic ITA harvest; 118 (54%) for off-pump coronary bypass grafting. RESULTS: The left ITA was harvested in 211 patients (96%); the mean harvest time ranged from 42 to 55 minutes. The ITA was injured in 4 patients (1.8%), and conversion to open ITA harvest occurred in 18 (8%). Complications included intercostal neuropathy (4), reoperation for ITA bleeding (2), phrenic nerve injury (1), and wound infection (1). CONCLUSIONS: This large, multicenter experience demonstrates that thoracoscopic harvest of the ITA can be accomplished safely and within a reasonable time frame in most patients undergoing coronary bypass grafting.     

U.S. mental health policy: Doomed to fail.

Changes in the de facto system of mental health care in the last decade reflect organizational and entrepreneurial responsiveness to changes in health policy, not mental health policy. Various other actions described here reduced statutory or institutional leadership roles in mental health and increased the pace at which mental health policy was becoming dependent on health policy. In turn, US health policy in the 20th century has been inherently flawed. The short-term general hospital, the "doctors' workshop," emphasizing acute care and surgery, has been the cornerstone of US health policy throughout the 20th century. The mimicry of health services by mental health leads to demonstrably more expensive and less effective mental health care and dooms mental health policy to failure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of the role of occupational health nursing in the U.S. and future perspectives in the U.S. and Japan

From 1988 to 1995, a bronchial washing was performed on 118 cases of middle lobe syndrome at the National Himeji Hospital. Twenty cases (16.9%) were positive for Mycobacterium avium complex (MAC). All cases were middle-aged (mean age 54.8), non-smoking women. Fourteen cases were asymptomatic and showed only abnormal shadow on chest X-ray film, while others complained cough, sputum or hemosputum. CT examinations were done on 13 patients, and pulmonary infiltrations were found in addition to right middle lobe or lingula in many cases. It is important to note that MAC infection might be one of causes of middle lobe syndrome.     

ISO 9000 and the U.S. Construction Industry

ISO 9000, the series of quality management standards issued by the International Organization for Standardization, is being used by organizations involved in construction all over the world. The construction industry in the United States has generally lagged behind other industries and other countries in the acceptance and implementation of ISO 9000 standards. Differing opinions surround the issue of ISO 9000 in the U.S. construction industry; it has received either the support or the criticism of experts, who weigh the effects of ISO 9000 as a matter of real improvements in quality against competitiveness and specific requirements at a domestic and international level. This paper attempts to determine the applicability and effectiveness of ISO 9000 in U.S. construction firms and the barriers that hinder its acceptance. The methodology used consists of a literature review and a survey distributed to a sample of firms that have or have not received ISO 9000 certification. After analyzing the gathered data, it was concluded that ISO 9000 is an appropriate and effective tool for construction firms in the United States, although several obstacles affect its implementation and acceptance among construction organizations.