Euthanasia and doctor-assisted suicide: responses by oncologists and non-oncologists

Plasmatic arterial necrosis and microaneurysm of small arteries are preceded by smooth muscle cell loss and the rupture of these arterial lesions is a direct cause of hypertensive intracerebral hemorrhage. The hypertensive brainstem hemorrhage occur exclusively in the pons. To elucidate whether there are differences of underlying arterial lesions between each part of the brainstem or not, small arteries in normal 34 autopsied brainstems were investigated histologically and morphometrically. Histological study revealed the predilection of the occurrence of plasmatic arterial necrosis, microaneurysms and fibronodular arterial lesions in the hypertensive pons. These lesions occurred predominantly in the small arteries 100-300 microns in diameter in the basal part of hypertensive pons, and were rare in the other parts of hypertensive brainstems and in normotensive brainstems. A negative correlation between the ratio of number of smooth muscle cell nuclei to the area of tunica media and age was demonstrated morphometrically. The ratio in the hypertensive group was significantly lower than that of the normotensive group. In addition the mean ratio in the pons was significantly lower than that in the midbrain and the medulla oblongata in the hypertensive group. These results are consistent with the fact that the hypertensive brainstem hemorrhage predominantly occur in the pons and primary bleedings in the other parts of the brainstem are rare.     

On starting conditions for a submerged sink in a fluid

The main purpose of the present work is the development of a general formulation for the flow of a Newtonian fluid over manifolds with curvature. The novel formulation includes an explicit contribution of the Ricci curvature in the diffusion of momentum and is applicable to flows that conserve a general volume: Riemannian or otherwise. The general solution of the Stokes flow on a sphere and the associated Stokeslet are also computed.     

Inhibition of sodium transport by prostaglandin E2 across the isolated, perfused rabbit collecting tubule

This study was designed to examine whether prostaglandin E2 can directly affect sodium transport across isolated perfused rabbit renal collecting tubules. Changes in transepithelial potential and isotopic sodium fluxes in response to peritubular prostaglandin E2 were measured. In addition, changes in transepithelial potential of the outer medullary collecting tubule in response to prostaglandin E2 were also measured. With few exceptions, all rabbits received 5 mg/day desoxycorticosterone acetate for 4-11 days before experimentation. The results of the experiments show that: (a) prostaglandin E2 inhibits the negative transepithelial potential in the cortical collecting tubule as well as the outer medullary collecting tubule; (b) prostaglandin E2 inhibits net sodium transport out of the lumen by inhibiting efflux while backflux is unaffected; (c) prostaglandin E2 produces this inhibition within 15 min, and the effects are dose dependent and reversible. These results suggest that prostaglandin E2 may modulate sodium transport in vivo and may contribute to the final regulation of sodium excretion.     

Using the patient as teacher: A training method for family practice residents in behavioral science.

Since the inception of family medicine as a specialty in allopathy and osteopathy in 1969 and 1973, respectively, there has been a need to develop integrative approaches of teaching behavioral science concepts without violating the scope of practice limitations between the fields. We describe a collaborative training method by which we attempt to achieve this balance. Residents referring patients for mental health services are involved in all phases of the mutual patient's treatment. The intake, recommendation, and feedback sessions are videotaped with both health care providers present. In this method, the necessity of keeping within the limited time constraints of medical schedules is recognized, the application of behavioral science concepts over theory is emphasized, and the role of the behavioral scientist as an equal partner in the team approach to health care is strengthened. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Microcounseling Skill Discrimination Scale: A methodological note.

Absolute ratings on the Microcounseling Skill Discrimination Scale (MSDS) confound the individual's use of the rating scale (response language) and actual ability to discriminate effective and ineffective counselor behaviors. The present article suggests methods of scoring the MSDS that will eliminate variability attributable to response language and thereby improve the validity of the instrument. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Arterial fasciocutaneous vascular territories of the lower leg

The purpose of this study was to analyze the fasciocutaneous arterial circulation of the lower extremity to provide a quantitative guide to design reliable fasciocutaneous flaps. Thirty-one fresh cadaver limbs were studied using the techniques of dissection of latex injected specimens, selective ink injections, and barium latex radiographs. Fasciocutaneous perforator locations were recorded according to fascial septum of origin and distance relative to bony landmarks between the knee and the ankle. Selective ink injections of the trifurcation vessels identified four anterior tibial, three peroneal, and three posterior tibial fasciocutaneous territories. Although perforator site locations were randomly distributed along the trifurcation vessel within any vascular territory, the separate cutaneous regions that make up the fasciocutaneous territories occur in predictable locations with a measurable standard deviation. The transverse section radiographs confirmed the transverse dimensions of the vascular territories. Additionally, the summation of any two vascular territories calculated from the anatomical data conforms to the clinically observed 2.5:1 to 3:1 length-to-width ratios for fasciocutaneous flap viability as reported by Ponten and by Barclay et al. This study provides a quantitative anatomical framework using primary fasciocutaneous vascular territories to design potentially reliable fasciocutaneous flaps in the lower extremity.     

Cardiac pacing electrodes

On the surface, the cardiac pacing lead is just a simple cable that connects the pulse generator to the heart. The simple appearance of the lead is very misleading, however. The size, longevity, and features of the pulse generator and the patient's safety depend to a large extent on the performance of the lead. The pacemaker must assure that the heart will contract with each stimulus. Thus the pacemaker must deliver a pulse of sufficient voltage and duration to stimulate with a sufficient safety factor to cope with any minute-to-minute variations that may occur in daily life. At the same time, it is necessary to use as little current as possible to maintain as long a battery longevity as is practical. The most common approaches to the problem of reliably delivering a stimulus with adequate safety margin while decreasing the current drained from the battery have traditionally centered around electrode size, materials, surface structure, shape, and more recently glucocorticosteroid sustained release. Relatively little effort has been directed reward optimizing the stimulus waveform for treatment of Brady arrhythmias     

Relation of verbal, affective, and physical intimacy to marital satisfaction.

Explored the relation of verbal, affective, and physical intimacy—to marital satisfaction in 43 couples (aged 18–59 yrs). The majority of Ss had sought counseling for marital problems. Ss completed questionnaires on intimacy and marital satisfaction and were then audiotaped during a discussion of their relationship. The 3 types of intimacy were highly predictive of both perceived marital satisfaction and a measure of thought and behaviors indicative of potential for divorce. Measures of verbal and affective intimacy made stronger contributions to the prediction of marital satisfaction than did physical intimacy. The interactions among the 3 types of intimacy did not contribute significantly to the prediction of satisfaction, nor was there any evidence of a curvilinear relation between measures of intimacy and measures of satisfaction. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-excited vibrations of optical microresonators

Microresonators in the form of metal coated silicon dioxide strips have been driven into resonant vibration by the application of unmodulated fibre-guided light. The experiments carried out to observe this phenomenon are described, their results presented and discussed, and the implications for multiplexing microresonators sensors in fibre-optic systems are outlined