Consent in the 90's

Patients consent to surgical procedures is a universal issue in medical law. The legal position in Australia, because it falls somewhere between the North American doctrine of "informed consent", and the Bolam test in the United Kingdom, will be of interest to all clinicians and legal practitioners dealing with these issues. The High Court of Australia's decision in Rogers v Whitaker (1992) 109 ALR 625 is now the leading decision regarding of consent to surgical procedures in Australia. The author draws a thumbnail sketch of the law in Australia, and discusses some loopholes in the legal structure established by the Australian High Court. The author supports the view taken by the High Court of Australia, and provides some material to contest the allegation made by clinicians that lawyers in Australia are in some way responsible to "opening the floodgates" for an increase in legal claims by patients.     

Cervical lymphatic tuberculosis in the 90's: a case report

The Authors report a clinical case of lymph nodal cervical TBC which led to a retropharyngeal abscess with ossifluent evolution towards the mediastinal region and with fistulation in the dorsal region. A thorough study was carried out on the diffusion of the liquid along the fascial plains of the prevertebral region of the neck and of the mediastinum. With the aid of radiologic tools (CAT scans in particular), and on the basis of topographical anatomy data Authors formulate an hypothesis concerning the mechanics that brought about such a downward development of the abscess. In our opinion this case may well be of interest for otolaryngologists from an epidemic point of view (there is a recrudescence often in atypical manifestations), and because of its surgical peculiarities.     

Cookbooks, manuals, and paint-by-numbers: Psychotherapy in the 90's.

Critically reviews the Division 12 Task Force Report on Promotion and Dissemination of Psychological Procedures and its update report and uses these reports as illustrative of flaws in contemporary psychotherapy research. The Task Force makes sweeping generalizations based on a paucity of research evidence. It does not address the issue of validation of manualization, nor the controversy over using manuals in psychotherapy. The complexities associated with measuring and assessing outcome are also ignored. Flaws common in contemporary psychotherapy displayed in the Task Force Report include the Type III Error, the exclusivity myth, "methodolatry," and oversimplification of the concept of outcome. While so flawed as to be of dubious value for researchers or practitioners, the Report and its accompaniments are worrisome in their potential appeal to those who might want to limit the use of psychotherapies only to those "validated" by the Task Force. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Estimate of mortality from occupational cancer and of carcinogen exposure in the workplace in Spain in the 90's

We estimated the number of cancers attributed to occupational exposures in Spain, and examined the prevalence of carcinogenic exposures in the workplace. We used population, labour, mortality and morbidity statistics and applied an approach used by Doll and Peto for the population of the USA. In men 6% and in women 1% of all cancers can be attributed to occupational exposures. Lung cancer accounts for 62% of all occupational cancers. About 402,346 men and women are employed in industries or occupations entailing a well recognised carcinogenic risk. In addition, a large but unquantifiable number of workers are employed in various other occupations and industries where exposure to carcinogenic chemical or physical agents may occur. The identification and control of carcinogenic exposures may lead to the prevention of a considerable number of cancers in the Spanish adult population.     

Country practice in the 1920's

Experiences in a country practice in the Eastern Cape and later in small town practice during the 1920s are described. Economic circumstances compelled me to become a general practitioner. I had regrets in 1924, but nor since then. General practice has been a rewarding experience.     

四十年代冯至的个体自觉与集体意识

上世纪四十年代是冯至创作的一个高峰.该时期作品带有强烈的个人思辨的色彩,也表现了他对个体存在本位的坚持.与此同时,冯至开始更多地强调个体时外物的关情,更多地转向对现实与集体的关注.个体自觉与集体意识在冯至四十年代的思想与创作中交锋,表面融合而实际背离,影响着冯至在四十年代末到五十年代的转向.从对冯至个体自觉与集体意识之间关系的分析,可窥见中国现代知识分子在启蒙话语中个人主体性建立的需求与当时中国社会现实、国族救亡、集体主义的复杂关系.     

Constitutive expression of heat shock protein 90 (HSP90) in neurons of the rat brain

Immunoblot analysis, immunocytochemistry and immuno-electron microscopy were employed to study the expression of HSP90 protein in the adult rat brain, using a specific polyclonal antiserum. Immunoblot analysis demonstrated equal levels of HSP90 in microdissected extracts from hippocampus, cortex, striatum and cerebellum. Immunocytochemistry and immuno-electron microscopy provided evidence that HSP90 is markedly expressed throughout all neuronal subpopulations of the CNS but not in non-neuronal cells except ependyma and choroid plexus. At the ultrastructural level, HSP90 immunoreactivity was predominantly found in perikarya but to a lesser extent also in dendrites and nuclei. The constitutive expression of HSP90 in widespread neuronal cell populations suggests a functional role in the physiological molecular program of CNS neurons.     

Meeting the challenge of diabetic blindness in the 90''s

We developed and characterized a model of global forebrain ischaemia in rats, permitting control of CBF at any desired ischaemic level with minimum surgery and without anticoagulation. Both common carotid arteries are occluded temporarily and systemic arterial pressure is lowered by pooling venous blood by lower body negative pressure with a cheap suction device. By measuring rCBF continuously (laser-Doppler-flowmetry) and regulating systemic arterial pressure, the model was used to automatically control cortical rCBF at predetermined ischaemic levels at 50, 30, 15, and 5% of normal rCBF (n = 5). When both common carotid arteries were occluded and systemic arterial pressure was lowered to 55 mmHg with hypobaric hypotension (n = 5), cortical CBF always fell to less than 5% of normal rCBF (n = 5). Prompt recirculation was achieved after reopening of the carotid arteries and return to normobaric body pressure. Hypobaric hypotension with bilateral common carotid occlusion requires only carotid surgery and measurement of systemic arterial pressure; it produces global forebrain ischaemia without anticoagulation as a true step function type insult. If rCBF is measured continuously, the model can be used to control ischaemic CBF to predetermined values.