By V. Owen. Saratoga University School of Law. 2018.
Several years later the collaborator was gious summer program at the Jackson Laboratory in Bar found to be innocent of all the charges raised against her purchase kamagra polo 100 mg impotence and diabetes. It Baltimore remained on the faculty of Rockefeller University was during this program that he met his future colleague buy 100mg kamagra polo with mastercard erectile dysfunction market, until 1994, when he returned to MIT as the Ivan R. Cottrell Howard Temin, and decided to pursue a career in scientific Professor of Molecular Biology and Immunology, and then research. During his career, David Baltimore has served on mainly by filamentous hyphae. They produce instead several different exoen- American Academy of Arts and Sciences, and the Royal zymes, which are released directly on their hosts through Society of London. At the end of 1996 he was appointed head invading filaments that can reach the target substance to be of the newly created AIDS Vaccine Research Committee of enzymatically decomposed. The exoenzymes are utilized in the National Institutes of Health, a group that supports all the digestion of the available organic substance from which efforts to accelerate the discovery of a vaccine against AIDS. They also contain in their cell membranes Immunogenetics; Viral genetics; Viral vectors in gene therapy; ergosterol, a sterol found exclusively in fungi. Viruses and responses to viral infection See also Chitin; Eukaryotes; Fungal genetics; Mycology BBasidomycetesASIDOMYCETES BATCH AND CONTINUOUS CULTURE • see Basidomycetes are a fungal group belonging to the Eukarya LABORATORY TECHNIQUES IN MICROBIOLOGY domain, which includes all life forms composed by nucleated cells. Basidomycetes are classified under the Fungi kingdom as belonging to the phylum –mycota (i. Some live in a sym- for the series of fundamental contributions he has made to the biotic relationship with plant roots (Mycorrhizae). He was the first per- termed basidium is responsible for sexual spore formation in son to visualize the yellow fever virus in cultured cells, and to Basidomycetes, through nuclear fusion followed by meiosis, obtain ultrathin sections of the changes caused to the cell wall thus forming haploid basidiospores. Fungi pertaining to the of Escherichia coli by the antibiotic penicillin. In the 1960s, he identi- that are formed when the two nuclei in the apical cell of a fied zones of adhesion between the inner and outer hypha divide simultaneously. Bayer’s rigorous experiments axis and the other into the clamp, thus giving origin to a tem- established that these adhesion zones that were apparent in porary monokaryotic clamp cell that is then fused to the sub thin sections of cells examined by the technique of transmis- apical cell, restoring the dikaryotic status. Spores are lined sion electron microscopy had biochemical significance e. Each spore usually for passage of viruses into the bacterium, specific site of cer- bears the haploid product of meiosis. In recognition of his efforts, the adhe- the spores may remain dormant for long periods, from months sion sites were dubbed “Bayer’s adhesion zones. When conditions are favorable, the spores germinate Bayer was born in Görlitz, Prussia (now Poland). A Following his high school education he enrolled in the biol- dikaryotic mycelium is formed as the result of the fusion of ogy program at the University of Kiel in Germany. Following this, he was accepted more often than not disseminated through the wind, either by for medical studies at the University of Hamburg, Germany. He completed his preclinical training in 1953 and clinical Basidomycetes comprises over 15,000 species, belong- training in 1955. From 1957 to 1959 he studied physics at the ing to 15 different orders, most of them wood-rotting species. During this same period he earned his Some examples of Basidomycetes are as follows: Coral accreditation as a physician, and undertook research studies Fungus or Ramaria, pertaining to the Hymeniales order; in pathology. This research led to a Research Associate posi- Stinkhorn or Phallus, from the Phallales order; Corn smut or tion at the University of Hamburg from 1957 to 1961. Also Ustilago, from the Ustilaginales order; Puffball or during this period Bayer undertook diploma studies at the Lycoperdon, from the Lycoperdales order; White Button Pizza university’s Institute of Tropical Medicine and Parasitology. The cell walls of fungi contain distinct layers, mainly From 1960 to 1962, Bayer was an Assistant Member of constituted by chitin and not by cellulose. Multicellular fungi the Institute of Tropical Diseases and Parasitology. Then, he such as mushrooms have their vegetative bodies constituted immigrated to the United States to take up the position of 57 Beckwith, Jonathan Roger WORLD OF MICROBIOLOGY AND IMMUNOLOGY Research Associate with The Institute of Cancer Research in Molecular Genetics in 1969). He has remained at the institute ever since, as an Professor in 1966, an Associate Professor in 1968, and a Assistant Member (1964–1967), Associate Member Professor in 1969. As membrane dynamics and division in the bacterium well, he was an Adjunct Professor for Microbiology at the Escherichia coli have been of fundamental importance in both University of Pennsylvania Medical School (1971–2000) and basic bacteriology and in the development of clinical strate- a Honorary Visiting Professor at Dalhousie University, gies to deal with Escherichia coli infections. The resins are used to solidify samples so that thin Beckwith has also been an active commentator on the social sections can be cut for electron microscopic examination. The scope and importance of Beckwith’s achievements In 1968, Bayer and his colleagues deduced the structure in fundamental bacterial genetics and societal aspects of of the structural units that form the hepatitis virus. Their dis- genetics have been recognized by his receipt of many awards covery led to the formulation of a vaccine. These include a Merit Award from the National In addition to his research activities, Bayer has been a Institutes of Health (1986), the Eli Lilly Award for outstanding teacher and mentor to hundreds of students over four decades.
Flexner offered a definition of science as the ‘persistent effort of men to purify generic 100mg kamagra polo with amex erectile dysfunction treatment maryland, extend and organise their knowledge of the world in which they live’ (Flexner 1925:3) buy discount kamagra polo 100 mg erectile dysfunction drugs walmart. He particularly emphasised the word ‘effort’, insisting that students should ‘strive to transcend native powers, prejudices, limitations’. This approach stands in sharp contrast to that of the new curriculum, in which the 148 THE CRISIS OF MODERN MEDICINE preoccupation with ‘relevance’ means elevating ‘native powers, prejudices and limitations’ over the systematic process of ‘observation, inference, verification and generalisation’ regarded by Flexner as the essence of the scientific method. For today’s medical teachers, students should find the course ‘enjoyable’ and be allowed to study at ‘their own pace and in their own time’ rather than being expected to make an effort to transcend their own limitations (Dent, 1993). More than a decade earlier in the USA, Lewis Thomas had warned against ‘notions of relevance’ that were ‘paralysing the minds of today’s first year medical students’ (Thomas 1979:141). The very fact that the medical curriculum has been repeatedly criticised for more than a century on the grounds that it is overloaded with facts—a period in which the ‘facts’ have changed considerably—suggests that this is a misconceived criticism. It implies a conception of medical science as a vast corpus of knowledge which has steadily increased in volume; from this perspective, medical education is a process of cramming all these facts into the student cranium. This approach confuses the process of scientific inquiry with its results: medical science is a method of understanding human health and disease, not a body of facts. The Nobel laureate Peter Medawar dismissed problems arising from the apparently ‘oceanic volume of scientific knowledge’ as ‘essentially technological problems, for which adequate technological solutions are rapidly being found’ (Medawar 1986:70). As Flexner wrote, ‘the teacher cannot provide the student with bits of information likely to be useful, nor can study be prolonged to include everything’ (Flexner 1925:13). The increase in the scale of medical knowledge over the past century makes no qualitative difference to this judgement. The key issue was not facts, but ‘habituation to method’; the role of the teacher was to select knowledge to exemplify scientific procedure. He insisted that ‘the facts in question cannot be passively learned and mechanically applied’ (Flexner 1925:13). The object of medical education was ‘primarily the effort to train students in the intellectual technique of inductive science’ This required ‘an extraordinarily active and oft-repeated mental process, involving observation, sorting out, combining, inferring, trying’. The real problem of medical teaching over the years has not been a surfeit of facts but a deficit of training in the intellectual technique of inductive science. Unfortunately, the promoters of the new curriculum have responded to popular criticisms of ‘overload’ by replacing inductive science with a vulgar empiricism. Medical 149 THE CRISIS OF MODERN MEDICINE science is disparaged as ‘knowledge’ and reduced to easily assimilated fragments of a ‘core’ curriculum, according to the criteria of relevance and enjoyability. The main concern of medical schools has shifted towards the inculcation of what are considered to be the correct attitudes. The Oxford physician David Weatherall is one of the few leading medical figures to have pointed—in a strikingly tentative way—to the dangers of this approach: While the motives behind these changes are admirable, it is essential that, while trying to improve the social, pastoral and communication skills of our future doctors, we do not dilute their scientific education. Indeed such teaching has extended rapidly into the post-graduate domain and into the ‘continuing medical education’ of practising doctors. Inadequacies in communication skills are one of the most frequently cited problems of ‘poorly performing doctors’ and the provision of appropriate tuition in this area is one of the functions of the ‘assessment and support centres’ proposed by the government. To anybody who has encountered a doctor who was rude or patronising or who spoke in incomprehensible medical jargon (and anecdotal evidence suggests that these are all familiar experiences) it would seem a good idea that medical students should be taught how to communicate with their future patients. In one widely used set of guidelines on communication, there is a striking combination of the most elementary ‘basic steps’ and suggestions about profoundly difficult matters such as ‘responding to patient feelings’ (Buckman 1994). No doubt it is possible to instruct students in ‘basic steps’, such as the importance of introductions, shaking hands, sitting down, listening attentively, etc. Perhaps in the past such conduct would have been regarded as simple good manners, which students might have been expected to acquire at home rather than at medical school. However, it may be fairly argued that the manifest lack of such elementary civility towards their patients among many doctors justifies including such instruction in the curriculum. Nevertheless, it is difficult to imagine that it would be necessary to spend more than a few minutes in an overcrowded curriculum on such tuition. Such skills fall into the category of things that can be learned by observation and reflection in clinical situations, not taught in a classroom (McCormick 1996). Indeed the very attempt to teach them in such a formal way underestimates the subtleties of doctor-patient communication which generations of doctors have painstakingly acquired through the sort of apprenticeship experience that is now so disparaged. The net effect of the promotion of comic- book communication skills is to elevate the banal while degrading what is profound in medical practice (Willis 1995:127). Clinical governance Clinical governance means the extension into the medical world of new mechanisms of regulation through audit that have been developed in business. These amount, according to Michael Power, professor of accountancy at the London School of Economics, to ‘the spread of a distinct mentality of administrative control, a pervasive logic which has a life of its own over and above specific practices’ (Power 1994). Power describes an ‘audit explosion’ in the late 1980s and early 1990s, as the term ‘began to be used in Britain with growing frequency in a wide variety of contexts’ (Power 1997: 3). A perception of a general deterioration in professional confidence and public trust in business and in services, in both private and public sectors, resulted in a quest for external guarantees of quality and probity. But audit is not a neutral process: when people subject their work to external monitoring, they inevitably find that this process leads to a reorganisation of their work to comply with the requirements of audit.
More detailed analysis to ascertain the nature of the the matrix that is formed by the gelling of agar generic 100mg kamagra polo with mastercard erectile dysfunction zoloft. This phenomenon forms the basis of the agar diffu- in microbiology sion assay that is used to determine the susceptibility or resist- ance of a bacterial strain to an antibacterial agent kamagra polo 100mg with amex impotence therapy, (e. AGGLUTINATION • see ANTIBODY-ANTIGEN, BIOCHEM- When the seaweed extract known as agar is allowed to ICAL AND MOLECULAR REACTIONS harden, the resulting material is not impermeable. Rather, there are spaces present between the myriad of strands of agar that comprise the hardened polymer. Small molecules such as AIDSAIDS antibiotics are able to diffuse through the agar. Typically, an antibiotic is applied to a well that is cut The advent of AIDS (acquired immunity deficiency syndrome) into the agar. Thus, the antibiotic will tend to move from this in early 1981 surprised the scientific community, as many region of high concentration to the surrounding regions of researchers at that time viewed the world to be on the brink of lower antibiotic concentration. AIDS, an infectious disease the well, then the zone of diffusion can be larger. A bacterial suspension is spread onto the sur- viruses known as retroviruses. There can be different concentrations of a infections that take hold of the body because the immune sys- single antibiotic or a number of different antibiotics present. Following a time to allow for growth of the bacteria then agar tem is severely impaired. If bacterial growth is right up to the antibiotic Following the discovery of AIDS, scientists attempted containing well, then the bacterial strain is deemed to be to identify the virus that causes the disease. If there is a clearing around the two scientists and their teams reported isolating HIV, the virus antibiotic well, then the bacteria have been adversely affected that causes AIDS. The size of the inhibition zone can be meas- Montagnier (1932– ), working at the Pasteur Institute in Paris, ured and related to standards, in order to determine whether and the other was American immunologist Robert Gallo the bacterial strain is sensitive to the antibiotic. Both identified HIV as the cause of AIDS and absorbent material that have been soaked with the antibiotic of showed the pathogen to be a retrovirus, meaning that its interest directly onto the agar surface. Following the discov- 7 AIDS WORLD OF MICROBIOLOGY AND IMMUNOLOGY ery, a dispute ensued over who made the initial discovery, but sion is that a person who has had another sexually transmitted today Gallo and Montagnier are credited as co-discoverers. Inside its host cell, the HIV retrovirus uses an enzyme Laboratories use a test for HIV-1 that is called Enzyme- called reverse transcriptase to make a DNA copy of its genetic linked immunosorbant assay (ELISA). The viral even though the disease attacks the immune system, B cells RNA in turn directs the synthesis protein capsids and both are begin to produce antibodies to fight the invasion within weeks assembled into HIV viruses. HIV destroys the immune sys- HIV-1 type antibodies and reacts with a color change. In addition, ELISA sub-Saharan Africa and subsequently spread to Europe and the may give a false positive result to persons suffering from a dis- United States by way of the Caribbean. Patients that test positive with ELISA are that suppress the immune system in monkeys, scientists given a second more specialized test to confirm the presence of hypothesize that these viruses mutated to HIV in the bodies of AIDS. Developed in 1996, this test detects HIV antigens, pro- humans who ate the meat of monkeys, and subsequently teins produced by the virus, and can therefore identify HIV caused AIDS. A fifteen-year-old male with skin lesions who before the patient’s body produces antibodies. During the 1960s, doctors often listed phase the infected individual may experience general flu-like leukemia as the cause of death in many AIDS patients. After symptoms such as fever and headache within one to three several decades however, the incidence of AIDS was suffi- weeks after exposure; then he or she remains relatively ciently widespread to recognize it as a specific disease. This stage continues for as long as the and distribution of diseases, turned their attention to AIDS. Progression of American scientist James Curran, working with the Centers the disease is monitored by the declining number of particular for Disease Control and Prevention (CDC), sparked an effort antibodies called CD4-T lymphocytes. First spread in the United immune cells by attaching to their CD4 receptor site. The States through the homosexual community by male-to-male virus also attacks macrophages, the cells that pass the antigen contact, HIV rapidly expanded through all populations. The progress of HIV can also be Presently new HIV infections are increasing more rapidly determined by the amount of HIV in the patient’s blood. After among heterosexuals, with women accounting for approxi- several months to several years, the disease progresses to the mately twenty percent of the AIDS cases. The worldwide next stage in which the CD4-T cell count declines, and non- AIDS epidemic is estimated to have killed more than 6. The CDC has established a definition for occurs about every fifteen seconds. HIV is not distributed the diagnosis of AIDS in which the CD4 T-cell count is below equally throughout the world; most afflicted people live in 200 cells per cubic mm of blood, or an opportunistic disease developing countries. In 1995 scientists developed the disease was concentrated in large cities, it has spread to a potent cocktail of drugs that help stop the progress of HIV.
Tom Norton Early seventies; white; married to Nelda buy 100 mg kamagra polo free shipping erectile dysfunction viagra free trials, with many grown children and grand- children; some college; retired business executive; high income; motor neuron disease (neurologic condition causing weakness in foot and leg); uses cane purchase 100 mg kamagra polo with mastercard treatment of erectile dysfunction in unani medicine. Eleanor Peters* Mid forties; black; several grandchildren; master’s degree; works for state voca- tional rehabilitation agency; polio as child; uses power wheelchair. Boris Petrov Mid forties; white, divorced, has girlfriend; surgeon in former Soviet Union but can no longer operate; volunteers helping other Russian immigrants; low income; thromboangiitis obliterans causing multiple amputations; uses power wheelchair. Petrov’s primary care physi- cian says he is doing “great,” exercising daily at a community center. Stella Richards Mid sixties; black; widowed, with one grown daughter; some college; retired ac- countant; middle income; spondylolisthesis (back problem); uses walker. Candy Stoops Late thirties; married with one young son; some college; retired administrative assistant; upper-middle income; myasthenia gravis; does not use mobility aids but has “slow days. Several years later, she’s attending school half-time and working as an administrative assistant half-time. Cynthia Walker* Mid thirties; white; married, with several young children; completed college; runs day care in home; arthritis (rheumatoid); periodically uses crutches. The list is not exhaus- tive, and the contact information is current as of July 2002. I grouped resources into four broad categories: health care professionals and providers; federal agencies and national organizations; links to information on the Internet; and state assistive technology projects. Other useful information emerges continu- ally, especially through disease-speciﬁc organizations and the Internet. Ap- pearance on this list does not imply an endorsement of speciﬁc organizations. Each person seeking information will have his or her own speciﬁc needs, and some sources will be more useful to individuals than other sources. Box 31220 Bethesda, MD 20824–1220 Phone: (301) 652–2682 TDD: (800) 377–8555 Fax: (301) 652–7711 http://www. Department of Justice ADA Information 950 Pennsylvania Avenue, NW Civil Rights Division Disability Rights Section—NYAVE Washington, D. Equal Employment Opportunity Commission 1801 L Street, NW Washington, D. Department of Health and Human Services 4770 Bufford Highway Atlanta, GA 30341 Phone: (770) 488–7150 Fax: (770) 488–7156 http://www. Department of Health and Human Services 8550 Arlington Boulevard, Suite 300 Fairfax, VA 22031 Phone: (800) 994-WOMAN http://www. Washington, DC 20202–2572 Phone: (202) 205–8134 TTY: (202) 205–4475 http://www. Box 6080 Morgantown, WV 26506–6080 Phone/TTY: (304) 293–7186 Phone/TTY: (800) 526–7234 Phone/TTY: (800) ADA-WORK Fax: (304) 293–5407 http://www. Francisco Boulevard, Suite L San Rafael, CA 94901 Phone: (415) 455–4575 TTY: (415) 455–0491 http://www. Each state develops its own program, which may be more or less applicable to adults with mobility limitations. These “Tech Act Projects” do not typically provide AT but instead offer information, support networks, demonstration centers, links to other state services, and other educational materials. Programs appear here alphabet- ically by state (current contact information on these programs is maintained at http://www. Alabama STAR System for Alabamians with Disabilities 2125 East South Boulevard P. Box 20752 Montgomery, AL 36120–0752 Phone: (334) 613–3480 Phone: (800) STAR656 (in state) Fax: (334) 613–3485 http://www. Box 5630 286 / Appendix 2 Flagstaff, AZ 86011 Phone: (520) 523–7035 TDD: (520) 523–1695 Fax: (520) 523–9127 http://www. Colfax Avenue, Suite 200 Denver, CO 80218 Phone: (303) 315–1280 Fax: (303) 837–8964 http://www. Box 269 Wilmington, DE 19899 Phone: (302) 651–6790 Appendix 2 / 287 Fax: (302) 651–6793 http://www. Lafayette Street, Suite 110 Tallahassee, FL 32301–4546 Phone/TDD: (850) 487–3278 Fax: (850) 487–2805 http://faast. Third Street Moscow, ID 83843 Phone: (208) 885–3559 Fax: (208) 885–3628 http://www. Old State Capitol Plaza, Suite 100 Springﬁeld, IL 62701 Phone/TDD: (217) 522–7985 288 / Appendix 2 Fax: (217) 522–8067 http://www. Paul, MN 55155 Phone: (612) 296–2771 Phone: (800) 657–3862 TDD: (612) 296–9478 http://www. Box 1698 Jackson, MS 39215–1000 290 / Appendix 2 Phone/TDD: (601) 987–4872 Fax: (601) 364–2349 E-mail: spower@mdrs. Michael’s Drive, Building D Sante Fe, NM 87505 Phone/TDD: (505) 954–8539 Phone/TDD: (800) 866–2253 Fax: (505) 954–8562 http://www.
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