Inguinal-mammary Enlargement in a Dog.

A 10-year-old female Fox Terrier was admitted to the Stange Memorial Clinic on June 23, 1944. The history presented was that of a growth on the mammary gland which had been slowly enlarging. The dog\u27s general condition appeared good; however, there was an enlargement in the left inguinal and posterior region. The enlargement extended from the immediate inguinal region to within 2 cm. posterior to the umbilicus. There was some deep fluctuation indicating the presence of an abscess. A diagnosis of neoplasm of the mammary gland with abscessation was made

AN ANALYSIS OF OSA JOHNSON - NOTED FEMALE EXPLORER

An Analysis of Osa Johnson Noted Female Explorer examines the life of the wife of famed African explorer Martin Elmer Johnson. It is the story of a love affair between two people who also shared a mutual love of animals and nature. Osa was initially the concerned wife who looked out after her husband and attempted to safeguard their lives in the early years of this century in a continent fraught with dangerous carnivores and instant death at every imaginable corner. She progressed from this to a position of leadership, shared with her husband, as they truly became a team of explorers dedicated to professional research by film. It can safely be concluded that Osa, while not an accepted equal to Martin in his work, (women photographers were little used or recognized in those days) clearly faced the same dangers. She lived the same life of deprivation, performed much the same routine work and obviously earned the professional recognition she later received for her accomplishments_ Fame, worldwide notoriety, and wealth meant little to this diminutive woman whose stature in her chosen field has eclipsed all who came before or after her

Generating High Purity Embryonic Stem Cell-derived Cell Populations for Transplantation Following Spinal Cord Injury

Embryonic stem cells hold great potential for cell replacement strategies in the central nervous system. Pre-differentiation into various neural cell types can help generate tissue-specific cell populations that can replace cells and tissue lost due to do injury or disease. A small number of undifferentiated pluripotent stem cells persist in most transplant populations even after pre-differentiation. Given the right environment, i.e. biomaterial scaffolds, these cells can lead to tumor formation thereby eliminating any potential therapeutic benefit. This dissertation focused on the development of high purity embryonic stem cell-derived cell populations devoid of pluripotent stem cells for transplantation into the central nervous system, in particular the injured spinal cord. In the first study, transgenic expression of the puromycin resistance enzyme, puromycin N-acetyltransferase, is driven by the gene regulatory elements of the progenitor motor neuron associated transcription factor Olig2. Selection by puromycin exposure resulted in an enriched population of progenitor motor neurons, as well as recent progeny of progenitor motor neurons. Furthermore, undifferentiated stem cells were removed by puromycin selection. The efficacy of these enriched populations was evaluated in tissue engineered fibrin scaffolds containing a heparin-based delivery system for controlled delivery of two growth factor combinations. Greater differentiation into oligodendrocytes in vitro was observed in selected cell groups compared to unselected controls in fibrin scaffolds delivery neurotrophin-3 and glial derived neurotrophic factor. Enriched progenitor motor neurons survived and differentiated into oligodendrocytes, astrocytes and motoneurons in a two week sub-acute dorsal hemisection model of spinal cord injury. Encapsulating the transplant population in the tissue engineered fibrin scaffold with growth factors did not enhance proliferation or survival suggesting that tumorgenic cell populations were not present. In the final study, high purity mature cholinergic motoneurons were generated by driving puromycin resistance under control of two highly conserved enhancers for the motoneuron transcription factor Hb9. Puromycin selection resulted in a uniform group of post-mitotic immature motoneurons. Purity was observed through maturation and no proliferating glia were observed at any time point. Selected motoneurons maintained appropriate electrophysiological characteristics. Through this work, antibiotic selection appears to be a suitable method for generating high purity ES-cell derived neural populations

Care of a Sitfast

On July 30, 1944, a 4-year-old Belgian mare was admitted to the Stange Memorial Clinic with a collar gall on the top of the neck. Such a gall is popularly known as a sitfast, which is caused by collar pressure on the top of the neck interfering with vascular supply to the area, resulting in necrosis. In time a definite necrotic plug or core forms. This pressure is frequently caused by a poor fitting collar or from the use of heavy, swinging tongue machinery

Student level II fieldwork failure: strategies for intervention.

OBJECTIVE: This report describes how common student communicative and behavioral characteristics that appear to predict the existence of potential problems during Level II fieldwork were identified in order to develop and implement preventative interventions during the academic curriculum at New York University (NYU). RECORD REVIEW: A record review of NYU professional-level occupational therapy students from 1986 to 1995 was completed to identify common factors among students who performed well academically but failed clinical fieldwork. Eight communicative and behavioral characteristics were identified: (a) rigidity of thinking, (b) discomfort with the ambiguity that accompanies clinical reasoning, (c) lack of psychological insight, (d) difficulty interpreting feedback, (e) externalization of responsibility, (f) difficulty learning from mistakes, (g) discomfort with the physical handling of patients, and (h) dependence on external measures for self-esteem. INTERVENTION: On the basis of the identified characteristics, five intervention strategies were adopted: (a) academic seminars that address professional behavior and interpersonal skills, (b) faculty feedback to students regarding problematic behaviors, (c) clinician and senior student counseling with identified students, (d) student remediation programs consisting of community service, and (e) student learning contracts based on specific behavioral objectives. These strategies were administered before Level II fieldwork to 10 students in the 1996 class who exhibited the characteristics indicative of potential fieldwork failure. OUTCOME: Of the 10 students in the 1996 class, 7 passed fieldwork without further difficulty, two failed fieldwork midterm assessments but went on to achieve passing final evaluations, and one failed the final fieldwork assessment but passed an additional third fieldwork experience. The class of 1996, which was the first to receive formal intervention designed to decrease fieldwork failure, demonstrated lower fieldwork failure rates than did all other classes in the past 10 years

On new characters of the eggs of Embioptera with the description of a new species of Saussurembia (Anisembiidae)

Nine egg characters for eleven species of Embioptera are described for the first time. Egg variability indicates its potential use in taxonomy. Here, we analyse the correlation of this variability with the ordinal classification. In addition, a new species of Saussurembia (Anisembiidae) from Trinidad is described, including classical traits in the systematics of Embioptera (adult male and female), as well as general features of the egg and maternal behaviour

Potential Overtreatment of Hyperglycemia in Older Adults: A Factorial Vignette Study of Primary Care Clinicians

University of Minnesota Ph.D. dissertation. July 2016. Major: Health Services Research, Policy and Administration. Advisor: Robert Kane. 1 computer file (PDF); ix, 108 pages.Background Diabetes is characterized by high blood sugar, or hyperglycemia. In addition to diet and exercise, several classes of medications are commonly used to treat hyperglycemia in type 2 diabetes in an attempt to reduce the downstream vascular complications of the disease. Four large trials showed few benefits and significant harms from attempting to achieve near normal glycemic control in middle aged people with type 2 diabetes. Benefits of aggressive glycemic control are further reduced for older adults with longstanding disease, those who have accumulated many of the complications of diabetes, and people with other comorbid conditions that limit life expectancy. This more complex older adult population is also at greater risk of iatrogenic hypoglycemia, a harm associated with treatment. For these reasons the American Diabetes Association and the American Geriatric Society have published guidelines recommending less stringent glycemic control for older adults with multiple comorbid conditions and limited life expectancies. However, little is known about how these guidelines are being implemented by primary care clinicians who provide most of the chronic disease management in the US. Methods A factorial vignette study was used to determine the effect of the patient characteristics mentioned in the existing guidelines on a clinician’s decision to prescribe a second-line treatment to achieve tighter glycemic control. The factors varied were patient age / disease duration (65 with short disease duration, 80 with long disease duration), cardiovascular disease (no heart disease, coronary artery disease with previous bypass), and cognitive impairment (no impairment, cognitive impairment that restricted ability to drive). Two policy-relevant glycated hemoglobin (HbA1c) levels were varied in the vignettes: 7.5% or 8.5%. Independent and combined effects of patient factors (patient complexity) were considered. Primary care clinicians from around the US were asked to participate via email. Clinician information was collected, including: years in practice, familiarity with treating older adults, and clinician type (family, internal, nurse practitioner). Clinicians were also asked to predict how likely the hypothetical patient was to adhere to their medication choices. Mixed effect models were used to account for the panel nature of the data (clinicians viewing multiple vignettes). Results 366 primary care clinicians from 36 states participated, with the majority of respondents practicing in Minnesota (35% of sample) or Florida (26% of sample). While we found some sensitivity to the patient factors mentioned in the existing guidelines, we also found evidence of overtreatment of the most complex hypothetical patients. For example, an 80-year-old with longstanding diabetes, cognitive impairment, and coronary artery disease requiring bypass had a second-line treatment added 35% of the time at a HbA1c level of 7.5%, and 75% of the time at a HbA1c of 8.5%. The same patient was recommended a sulfonylurea or insulin (agents known to increase the risk of iatrogenic hypoglycemia) 36% of the time at a HbA1c level of 7.5% and 44% of the time at a HbA1c level of 8.5%. Family practice physicians were less likely to add an additional medication than internal medicine physicians or nurse practitioners. Clinicians did not incorporate their adherence predictions into their decisions to intensify medication therapy. Conclusions This work is part of a larger discussion around balancing the risks and benefits of aggressively treating hyperglycemia in older adults with type 2 diabetes for whom tight glycemic control produces few benefits and significantly increases risk for iatrogenic hypoglycemia. Clinicians may treat more aggressively than guidelines recommend because they are unfamiliar with the geriatric-specific guidelines or they may work in settings where performance incentives are tied to achieving HbA1c levels recommended for average or healthier patients. As few benefits and serious harms are associated with overtreatment, policy recommendations include: 1. creating performance incentives to reduce anti-glycemic medication therapy when appropriate; and 2. developing tools to help primary care clinicians evaluate and address complexity and life expectancy in their older patients with multiple chronic conditions

Imaging the developing human external and internal urogenital organs with light sheet fluorescence microscopy.

Technological advances in three-dimensional (3D) reconstruction techniques have previously enabled paradigm shifts in our understanding of human embryonic and fetal development. Light sheet fluorescence microscopy (LSFM) is a recently-developed technique that uses thin planes of light to optically section whole-mount cleared and immunolabeled biologic specimens. The advent of commercially-available light sheet microscopes has facilitated a new generation of research into protein localization and tissue dynamics at extremely high resolution. Our group has applied LSFM to study developing human fetal external genitalia, internal genitalia and kidneys. This review describes LSFM and presents our group's technique for preparing, clearing, immunostaining and imaging human fetal urogenital specimens. We then present light sheet images and videos of each element of the developing human urogenital system. To the extent of our knowledge, the work conducted by our laboratory represents the first description of a method for performing LSFM on the full human urogenital system during the embryonic and fetal periods