By E. Vandorn. Bryan College. 2018.

During his career allegra 180 mg on line allergy testing experience, David Baltimore has served on mainly by filamentous hyphae cheap 120mg allegra with amex allergy forecast edmond ok. 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.

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Throughout the years tice for many years buy 120mg allegra overnight delivery allergy testing kent, but he now had time to devote he remained known with affection by his patients himself to his other great interest in life—music discount allegra 120 mg with mastercard allergy forecast alabama. Now he took classes in music at the 357 Who’s Who in Orthopedics University of Otago and reached the stage when Boston. Gibney, He then spent a prolonged visit to England, at the Hospital for the Ruptured and Crippled. He devel- The association with this hospital continued until oped a deep interest in the ancient churches of 1929, when, after 40 years of continuous service, London and compiled a vast manuscript dealing he retired from both hospital and private practice. On his return to He moved to England, where he remained for Dunedin in 1961, he was immensely busy prepar- about 13 years, returning to his own country in ing it for publication, but this was not to be—he 1943. He was a foundation fellow of the Royal Three days before his death, he received an invi- Australasian College of Surgeons. The British tation to represent the United States, as a guest of Orthopaedic Association honored him by electing the French Government, at a meeting to celebrate him an emeritus fellow and the New Zealand the 100th anniversary of the founding of the Orthopedic Association its patron. Whitman was a member of many medical man, vivacious, erudite and immensely versatile. By the death of James Renfrew American Orthopedic Association, of which he White of Dunedin on December 27, 1961, New was president in 1895. Zealand lost the doyen of her orthopedic He was an indefatigable worker. The patients were seen first in the outpatient department and, after their stay in the hospital for operative or nonoperative treatment, returned to it for follow-up care or observation. Hence, he, as well as all of his associates, attended the outpatient clinic. The clinic hours ran from one to three in the after- noon, and so prompt was his arrival that watches could be set at one o’clock when he entered the hospital. He had little patience with an assistant who came late or who offered excuses for ir- regular attendance. In this, as in so many other respects, he set his assistants an excellent example. Whitman loved orthopedic surgery and sought continuously and zealously to advance it. To those who saw him and worked with him 4 or 5 days a week, he seemed to be thinking of nothing but orthopedics. During a lull in clinic work in the afternoons, the subject discussed was never art, literature, music, or politics, but always Royal WHITMAN orthopedic surgery, a difficult case for diagnosis, 1857–1946 surgical technique, mechanical or surgical prin- ciples, or orthopedic literature. Whitman read Royal Whitman was born in Portland, Maine, on extensively and was thoroughly informed on the October 24, 1857. He received his degree of orthopedic literature in English, French, and Doctor of Medicine from Harvard Medical German; he expected all of his associates to be School in 1882, and for a while he practiced in equally well informed and up to date, so that dis- 358 Who’s Who in Orthopedics cussions, which were very frequent, would be lent anatomist and, through hints dropped here most fruitful and thought-provoking. Whitman was a profound student of ortho- anatomy; second, on the day before an operation pedic surgery, a pioneer, and a pathfinder. He was he continuously reviewed what he contemplated always trying out new procedures, either those he doing, and hence he came to the operating table initiated or those suggested by others. He avoided an insatiable curiosity about the pathogenesis of complicated operations, believing that the goal orthopedic diseases and deformities, and an imag- could be attained through simple measures. He was his own sternest operation was rarely an emergency procedure, critic and never reported favorably upon any and that the end result would be better if he used technique or procedure until he himself was several simple separate operations. When he He taught orthopedic surgery for 40 years, both became convinced of the value of any treatment, at the College of Physicians and Surgeons of he would, through addresses or medical essays, Columbia University and at the Hospital for the hammer away at the profession until his opinion Ruptured and Crippled. His method of teaching was not always a manual correction of deformities, of which he placid procedure. Although short of stature and thin, not always agreeable, method of sarcastic criti- he many times surprised his young and more vig- cism. His students, orous assistants by the rapidity and ease with however, soon recognized the light in his eyes and which he would correct a resistant deformity over the smile on his lips, and knew that there was no which they had labored ineffectually. He meant only to em- when the use of great manual force was condoned phasize indelibly some point in observation, in the correction of a club foot or the reduction of diagnosis, or surgical technique. To the less a congenital dislocation of the hip, he exhibited understanding students and visitors, this peda- remarkable dexterity and strength in overcoming gogic method was disconcerting. Whitman was particularly insistent upon a As an investigator and teacher, Dr.

Bladder neck injections with bulking agents have a less reliable record in this difficult group discount allegra 180 mg on-line allergy treatment nursing. Artificial urinary sphincters (AUS) have an excellent record of continence buy generic allegra 120 mg on line allergy symptoms loss of voice, but there is a higher attrition rate in paraplegics due to infection or cuff erosion, especially if ISC is undertaken regularly. Placement around the bulbar urethra should be avoided in patients confined to a wheelchair, and impotence frequently complicates cuff placement in the membranous position. For both male and female paraplegic patients the bladder neck is therefore the optimal site for AUS cuff placement. The acontractile bladder and assisted voiding Since the adoption and widespread use of intermittent Figure 7. Most patients with good hand function manage the technique, though paraplegic females have more difficulty accessing their urethra. This may be sufficient to cause them to abandon attempts in favour of long-term suprapubic catheterisation. Since Mitrofanoff first described his technique in children, the procedure has been adapted to other circumstances, including stomal intermittent self-catheterisation in the paraplegic wheelchair-bound female patient. Even in tetraplegic patients with limited hand function stomal ISC is sometimes feasible with careful siting of the channel. In those patients who have undergone a Mitrofanoff procedure, stomal ISC is usually regarded as preferable to urethral catheterisation, and females whose native urethra remains in situ and who have a stoma almost never catheterise their own urethra. Complications of the procedure are irritatingly frequent though rarely life-threatening. Minor “plastic” procedures for stomal stenosis are required in up to 30% of cases and complete channel revisions for leakage or failure are necessary in 15%. The procedure may be undertaken in conjunction with bladder augmentation and/or bladder neck closure for intractable incontinence. This may have colorectal dysfunction—use of the new antegrade and a devastating impact on rehabilitation, and the urologist should retrograde colonic wash-out methods. Malone 2000;38:255–61 described the effectiveness of the antegrade colonic • Galloway A. Prevention of urinary tract infection in patients (continence) enema (ACE) in children with with spinal cord injury—a microbiological review. Spinal meningomyelocoele, and it may be helpful in managing Cord 1997;35:198–204 sphincter weakness faecal incontinence secondary to cauda • Giannantoni A, Scivoletto G, Di Stasi SM et al. The procedure (like the Mitrofanoff) intermittent catheterisation and the prevention of renal consists of the construction of a self-catheterising channel from disease in spinal cord injury. Spinal Cord 1998;36:29–32 appendix or tapered small bowel between abdominal wall and • Kelly SR, Shashidharan M, Borwell B et al. Every 48 hours or thereabouts, intestinal stoma in patients with spinal cord injury. Spinal the bowel is intubated via the stoma, and a large volume enema Cord 1999;37:211–14 (e. The ACE suprapubic catheterisation: clinical outcome and procedure is much less effective in treating the profound satisfaction survey. Spinal Cord 1998;36:171–6 constipation frequently encountered in suprasacral SCI. Continent procedure can be performed simultaneous to a Mitrofanoff, ileocecal augmentation cystoplasty. Spinal Cord colposuspension, urethral closure, or bladder neck cuff 1998;36:246–51 implantation, although the remaining components of the AUS • Weld KJ, Dmochowski RR. Effect of bladder management should not be implanted due to the risk of infection. J Urol 2000;163:768–72 40 8 Nursing Catriona Wood, Elizabeth Binks, David Grundy The main nursing objectives in providing care for people who have sustained a spinal cord lesion are to: identify problems Box 8. Nurses need to recognise that patients will spend a long time in hospital, probably between four and nine months. Most patients are male (4:1 men to women) aged between 15 and 40 years, but an increasing number of older people are sustaining injuries. Patients will initially be very dependent on others, and those with high lesions or from the older age group may continue to be dependent and have a disappointing level of neurological recovery and functional outcome.

In later life purchase 120mg allegra otc allergy symptoms feel like flu, pulmonary Frank Holdsworth was one of the great orthope- disease and his strenuous work slowly sapped his dic surgeons of his generation buy allegra 120 mg low price allergy shots hurt, but the achieve- strength but never his bonhomie nor his endear- ments for which he will be remembered extended ing kindness. He was a fine teacher, a great In 1937, he retired from private practice and innovator, and in his later years an almost fanati- moved with his family to the lovely old town of cal campaigner for a sound and rational system Beaufort, South Carolina. Hoke’s health campaign his prime consideration was to get a was better, and his passing came as a shock to his square deal for the young man in training, and he numberless friends. Few younger generations doing a sum; to hammer out as compact and solid can have had such a redoubtable champion from a piece of work as you can; to try to make it first the ranks of the older, and although for many rate and to leave it unadvertised. At the time of his death he was within an ace of seeing all the reforms and ideas for which he had striven so hard and so long finally accepted and put into practice. Frank Holdsworth was born and brought up in Bradford and, apart from his years of training, first at Cambridge, where he was an exhibitioner, and then at St. George’s Hospital in London, he spent the whole of his professional life in Sheffield. So he was a true Yorkshireman, and made no bones about it; which means that he was uncomplicated, direct, transparently honest, 145 Who’s Who in Orthopedics warm hearted, occasionally irascible, utterly reli- where once a week the entire staff presented their able, a bit stubborn (he used to say pig-headed), problem cases for discussion. The particular con- completely loyal and quite incapable of being ference that we attended developed into an almost spoiled either by power or success or anything gladiatorial contest with such orthopedic giants as else. Most people who scale the heights as he did Smith-Petersen, Joe Barr, Bill Rogers and Eddie are affected in some degree by it, but I doubt if Cave taking part. Frank Holdsworth, who had he changed in the slightest during the 30-odd visited many continental clinics where, in those years that I knew him so well. In those days there was no segregation of ferences were open to all orthopedic surgeons and orthopedics and trauma, but within a few years their junior staff in and around Sheffield, and the and with the help and encouragement of Sir atmosphere was delightful. They were completely Ernest, he was elevated to the staff and given informal and friendly, there was no showing off, the job of creating an orthopedic and accident and cases were presented only because they were service. He developed it, as everyone knows, into problems about which advice was needed. He one of the most famous units in Britain and a always insisted on starting the discussion at reg- “must” for every foreign orthopedic surgeon vis- istrar level and working up in order to discourage iting this country. His own that he later introduced the rotating registrar intellectual honesty somehow washed off onto system, an innovation that has since become everybody who became regularly associated with popular all over Britain, and he was justly proud him in this way, and although a little coat-trailing of the fact that in all the years of its operation only or kite-flying was occasionally permitted in order one registrar left the rotation without gaining the to liven up a discussion, the general rule was that, FRCS. He Working as he did in a highly industrialized was a particularly severe debunker of loose think- area of steel and coalmining, he always had a par- ing or armchair theorizing. On one occasion when ticular interest in accident surgery, and being the my own kite had got a little out of control he pref- kind of surgeon who, to use his own words, liked aced his summing up by saying that he had never to see the ball in the back of the net, he became heard me talk quite so much out of my hat and one of an early pioneer group who developed the then proceeded to take me apart and leave the concept of rehabilitation in this country. The juniors loved under the auspices of the then Miners’ Welfare it, of course, but at the end of the conference he Commission, before the advent of the National took me aside and asked if I would go along and Health Service. Later, under the same auspices, he see a patient with him because, as he said: “I think was one of a small group to visit Canada and the I’ve made a pig’s ear of it”—another favorite United States to study the problems of paraplegia, expression of his, which, translated into standard then a scourge in the mining industry. Paraplegia southern English, meant that it was not quite remained one of his major interests throughout coming up to expectations. It was small incidents the rest of his career and he became an interna- of this kind that revealed something of the char- tional authority on the subject. He he succeeded in establishing the spinal injuries had no time for sycophants or for any form of unit at Lodge Moor Hospital in Sheffield, not as insincerity, and every member of his team was a center for dealing with the terrible complica- expected to say what he thought and call a spade tions of paraplegia but as an early transfer unit a spade. He trained many fine surgeons, some of where these complications could be prevented. The unit always remained a team, the staff conference in action, notably in Boston, every member regarding him with great respect 146 Who’s Who in Orthopedics and affection. Indeed, this applied to everyone ugly uncivilised North,” he would say, “or they’ll who worked with him, including the many all come up from the South and spoil it. He left behind his wife Marjorie, herself a York- He was essentially a modest man and although shire woman endowed with many of his own ster- he had so strong a personality and such gifts of ling qualities, his son John and his daughter Mary. Indeed, he was always faintly surprised at finding himself famous and sought after, and although he knew for years that the writing was on the wall, he refused to make any concessions. To the despair of friends and medical advisers alike, he continued to drive himself as hard as ever in the many high offices to which he was called—President of the British Orthopedic Association, Senior Vice President of the Royal College of Surgeons of England, Examiner to the College and to many universities apart from his own, and a much sought after lecturer in many parts of the world. Even in his last year he visited the United States twice and on the last occasion was made an Honorary Fellow of the American College of Surgeons—an honor very rarely awarded to surgeons outside that country. His knighthood in 1967, followed by a professorship in 1969 in his own university, made a fitting climax to a brilliant career.

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