Holoprosencephaly

Holoprosencephaly (HPE) is a cephalic disorder in which the prosencephalon (the forebrain of the embryo) fails to develop into two hemispheres. Normally, the forebrain is formed and the face begins to develop in the fifth and sixth weeks of human pregnancy. The condition also occurs in other species.
The condition can be mild or severe. Most cases are not compatible with life and result in fetal death in utero.
When the embryo's forebrain does not divide to form bilateral cerebral hemispheres (the left and right halves of the brain), it causes defects in the development of the face and in brain structure and function.
In less severe cases, babies are born with normal or near-normal brain development and facial deformities that may affect the eyes, nose, and upper lip.
Signs and symptoms.
Symptoms of holoprosencephaly range from mild (no facial/organ defects, anosmia, or only a single central incisor) to moderate to severe (cyclopia).
There are four classifications of holoprosencephaly.
Holoprosencephaly consists of a spectrum of defects or malformations of the brain and face. At the most severe end of this spectrum are cases involving serious malformations of the brain, malformations so severe that they often cause miscarriage or stillbirth. At the other end of the spectrum are individuals with facial defects which may affect the eyes, nose, and upper lip - and normal or near-normal brain development. Seizures and intellectual disabilities may occur.
The most severe of the facial defects (or anomalies) is cyclopia, an abnormality characterized by the development of a single eye, located in the area normally occupied by the root of the nose, and a missing nose or a nose in the form of a proboscis (a tubular appendage) located above the eye. The condition is also referred to as cyclocephaly or synophthalmia, and is very rare.
Causes.
The exact cause(s) of HPE are yet to be determined. Mutations in the gene encoding the Sonic Hedgehog protein, which is involved in the development of the central nervous system (CNS), can cause holoprosencephaly. In other cases, it often seems that there is no specific cause at all.
Genetics.
Armand Marie Leroi describes the cause of cyclopia as a genetic malfunctioning during the process by which the embryonic brain is divided into two. Only later does the visual cortex take recognizable form, and at this point an individual with a single forebrain region will be likely to have a single, possibly rather large, eye (at such a time, individuals with separate cerebral hemispheres would form two eyes).
Increases in expression of such genes as Pax-2, as well as inhibition of Pax-6, from the notochord have been implicated in normal differentiation of cephalic midline structures. Inappropriate expression of any of these genes may result in mild to severe forms of holoprosencephaly. Other candidate genes have been located, including the SHH (holoprosencephaly type 3 a.k.a. HPE3), TGIF, ZIC2, SIX3 and BOC genes.
Although many children with holoprosencephaly have normal chromosomes, specific chromosomal abnormalities have been identified in some patients (trisomy of chromosome 13, also known as Patau syndrome). There is evidence that in some families, HPE is inherited (autosomal dominant as well as autosomal or X-linked recessive inheritance). Features consistent with familial transmission of the disease (e.g., a single central maxillary incisor) should be carefully assessed in parents and family members.
Non-genetic factors.
Numerous possible risk factors have been identified, including gestational diabetes, transplacental infections (the "TORCH complex"), first trimester bleeding, and a history of miscarriage. As well, the disorder is found twice as often in female babies. However, there appears to be no correlation between HPE and maternal age.
There is evidence of a correlation between HPE and the use of various drugs classified as being potentially unsafe for pregnant and lactating mothers. These include insulin, birth control pills, aspirin, lithium, thorazine, retinoic acid, and anticonvulsants. There is also a correlation between alcohol consumption and HPE, along with nicotine, the toxins in cigarettes and toxins in cigarette smoke when used during pregnancy.
Prognosis.
HPE is not a condition in which the brain deteriorates over time. Although serious seizure disorders, autonomic dysfunction, complicated endocrine disorders and other life-threatening conditions may sometimes be associated with HPE, the mere presence of HPE does not mean that these serious problems will occur or develop over time without any previous indication or warning. These abnormalities are usually recognized shortly after birth or early in life and only occur if areas of the brain controlling those functions are fused, malformed or absent.
Prognosis is dependent upon the degree of fusion and malformation of the brain, as well as other health complications that may be present.
The more severe forms of encephalopathy are usually fatal. This disorder consists of a spectrum of defects, malformations and associated abnormalities. Disability is based upon the degree in which the brain is affected. Moderate to severe defects may cause intellectual disability, spastic quadriparesis, athetoid movements, endocrine disorders, epilepsy and other serious conditions; mild brain defects may only cause learning or behavior problems with few motor impairments.
Seizures may develop over time with the highest risk before 2 years of age and the onset of puberty. Most are managed with one medication or a combination of medications. Typically, seizures that are difficult to control appear soon after birth, requiring more aggressive medication combinations/doses.
Most children with HPE are at risk of having elevated blood sodium levels during moderate-severe illnesses, that alter fluid intake/output, even if they have no previous diagnosis of diabetes insipidus or hypernatremia.


Pectus excavatum

Pectus excavatum is a structural deformity of the anterior thoracic wall in which the sternum and rib cage are shaped abnormally. This produces a caved-in or sunken appearance of the chest. It can either be present at birth or develop after puberty.
Pectus excavatum can impair cardiac and respiratory function and cause pain in the chest and back.
People with the condition may experience severe negative psychosocial effects and avoid activities that expose the chest.
Signs and symptoms.
The hallmark of the condition is a sunken appearance of the sternum. The most common form is a cup-shaped concavity, involving the lower end of the sternum; also a broader concavity involving the upper costal cartilages is possible. The lower-most ribs may protrude ("flared ribs"). Pectus excavatum defects may be symmetric or asymmetric.
People may also experience chest and back pain, which is usually of musculoskeletal origin.
In mild cases, cardiorespiratory function is normal, although the heart can be displaced and/or rotated. In severe cases, the right atrium may be compressed, mitral valve prolapse may be present, and physical capability may be limited due to base lung capacity being decreased.
Psychological symptoms manifest with feelings of embarrassment, social anxiety, shame, limited capacity for activities and communication, negativity, intolerance, frustration, and even depression.
Causes.
Researchers are unsure of the cause of pectus excavatum. Some researchers take the stance that it is a congenital disorder (birth defect) (that is, not genetic) like cleft lip. Others assume that there is some genetic component. A small sample size test found in least some cases, 37% of individuals have an affected first degree family member. As of 2012, a number of genetic markers for pectus excavatum have also been discovered.
It was believed for decades that pectus excavatum is caused by an overgrowth of costal cartilage, however people with pectus excavatum actually tend to have shorter, not longer, costal cartilage relative to rib length.
Pectus excavatum can be present in other conditions too, including Noonan syndrome, Marfan syndrome and Loeys–Dietz syndrome as well as other connective tissue disorders such as Ehlers–Danlos syndrome. Many children with spinal muscular atrophy develop pectus excavatum due to their diaphragmatic breathing.
Pathophysiology.
Physiologically, increased pressure "in utero", rickets and increased traction on the sternum due to abnormalities of the diaphragm have been postulated as specific mechanisms. Because the heart is located behind the sternum, and because individuals with pectus excavatum have been shown to have visible deformities of the heart seen both on radiological imaging and after autopsies, it has been hypothesized that there is impairment of function of the cardiovascular system in individuals with pectus excavatum. While some studies have demonstrated decreased cardiovascular function, no consensus has been reached based on newer physiological tests such as echocardiography of the presence or degree of impairment in cardiovascular function. However, a 2016 meta-analysis found significant evidence that surgical correction of pectus excavatum improves patient cardiac performance.
Diagnosis.
Pectus excavatum is initially suspected from visual examination of the anterior chest. Auscultation of the chest can reveal displaced heart beat and valve prolapse. There can be a heart murmur occurring during systole caused by proximity between the sternum and the pulmonary artery.
Lung sounds are usually clear yet diminished due to decreased base lung capacity.
Many scales have been developed to determine the degree of deformity in the chest wall. Most of these are variants on the distance between the sternum and the spine. One such index is the "Backer ratio" which grades severity of deformity based on the ratio between the diameter of the vertebral body nearest to xiphosternal junction and the distance between the xiphosternal junction and the nearest vertebral body. More recently the "Haller index" has been used based on CT scan measurements. An index over 3.25 is often defined as severe. The Haller index is the ratio between the horizontal distance of the inside of the ribcage and the shortest distance between the vertebrae and sternum.
Chest x-rays are also useful in the diagnosis. The chest x-ray in pectus excavatum can show an opacity in the right lung area that can be mistaken for an infiltrate (such as that seen with pneumonia). Some studies also suggest that the Haller index can be calculated based on chest x-ray as opposed to CT scanning in individuals who have no limitation in their function.
Pectus excavatum is differentiated from other disorders by a series of elimination of signs and symptoms. Pectus carinatum is excluded by the simple observation of a collapsing of the sternum rather than a protrusion. Kyphoscoliosis is excluded by diagnostic imaging of the spine, where in pectus excavatum the spine usually appears normal in structure.
Treatment.
Pectus excavatum requires no corrective procedures in mild cases. Treatment of severe cases can involve either invasive or non-invasive techniques or a combination of both. Before an operation proceeds several tests are usually performed. These include, but are not limited to, a CT scan, pulmonary function tests, and cardiology exams (such as auscultation and ECGs). After a CT scan is taken, the Haller index is measured. The patient's Haller is calculated by obtaining the ratio of the transverse diameter (the horizontal distance of the inside of the ribcage) and the anteroposterior diameter (the shortest distance between the vertebrae and sternum). A Haller Index of greater than 3.25 is generally considered severe, while normal chest has an index of 2.5. The cardiopulmonary tests are used to determine the lung capacity and to check for heart murmurs.
Conservative treatment.
The chest wall is elastic, gradually stiffening with age. Non-surgical treatments have been developed that aim at gradually alleviating the pectus excavatum condition, making use of the elasticity of the chest wall, including the costal cartilages, in particular in young cases.
Exercise.
Physical exercise has an important role in conservative pectus excavatum treatment though is not seen as a means to resolve the condition on its own. It is used in order to halt or slow the progression of mild or moderate excavatum conditions and as supplementary treatment to improve a poor posture, to prevent secondary complications, and to prevent relapse after treatment.
Exercises are aimed at improving posture, strengthening back and chest muscles, and enhancing exercise capacity, ideally also increasing chest expansion. Pectus exercises include deep breathing and breath holding exercises, as well as strength training for the back and chest muscles. Additionally, aerobic exercises to improve cardiopulmonary function are employed.
Vacuum bell.
"See also Vacuum Bell".
An alternative to surgery, the vacuum bell, was described in 2006; the procedure is also referred to as treatment by "cup suction". It consists of a bowl shaped device which fits over the caved-in area; the air is then removed by the use of a hand pump. The vacuum created by this lifts the sternum upwards, lessening the severity of the deformity. It has been proposed as an alternative to surgery in less severe cases. Once the defect visually disappears, two additional years of use of the vacuum bell is required to make what may be a permanent correction. The treatment, in combination with physiotherapy exercises, has been judged by some as "a promising useful alternative" to surgery provided the thorax is flexible; the duration of treatment that is required has been found to be "directly linked to age, severity and the frequency of use". Long-term results are still lacking.
The vacuum bell can also be used in preparation to surgery.
Orthoses.
Brazilian orthopedist Sydney Haje developed a non-surgical protocol for treating pectus carinatum as well as pectus excavatum. The method involves wearing a compressive orthosis and adhering to an exercise protocol.
Mild cases have also reportedly been treated with corset-like orthopedic support vests and exercise.
Thoracic surgery.
There has been controversy as to the best surgical approach for correction of pectus excavatum. It is important for the surgeon to select the appropriate operative approach based on each individual's characteristics.
 Surgical correction of the pectus excavatum has been shown to significantly improve cardiovascular function; there is inconclusive evidence so far as to whether it might also improve pulmonary function. One of the most popular techniques for repair of pectus excavatum today is the minimally invasive operation, also known as MIRPE or Nuss technique.
Magnetic mini-mover procedure.
The magnetic mini-mover procedure (3MP) is a minimally invasive procedure used to correct pectus excavatum by using two magnets to realign the sternum with the rest of the chest and ribcage. One magnet is inserted 1 cm into the patient's body on the lower end of the sternum, the other is placed externally onto a custom fitted brace. These two magnets generate around 0.04 tesla (T) in order to slowly move the sternum outwards over a number of years. The maximum magnetic field that can be applied to the body safely is around 4 T, making this technique safe from a magnetic viewpoint. The 3MP technique's main advantages are that it is more cost-effective than major surgical approaches such as the Nuss procedure and it is considerably less painful postoperatively.
Its effectiveness is limited to younger children in early- to mid-puberty because older individuals have less compliant (flexible) chest walls. One potential adverse interaction with other medical devices is possible inactivation of artificial pacemakers if present.
Ravitch technique.
The Ravitch technique is an invasive surgery that was introduced in 1949 and developed in the 1950s. It involves creating an incision along the chest through which the cartilage is removed and the sternum detached. A small bar is inserted underneath the sternum to hold it up in the desired position. The bar is left implanted until the cartilage grows back, typically about six months. The bar is subsequently removed in a simple out-patient procedure; this technique is thus a two-stage procedure.
The Ravitch technique is not widely practiced because it is so invasive. It is more often used in older individuals, where the sternum has calcified, when the deformity is asymmetrical, or when the less invasive Nuss procedure has proven unsuccessful.
Nuss procedure.
In 1987, Donald Nuss, based at Children's Hospital of The King's Daughters in Norfolk, Virginia, performed the first minimally invasive repair of pectus excavatum (MIRPE) and presented it much later at a conference in 1997.
His procedure, widely known as the "Nuss procedure", involves slipping in one or more concave steel bars into the chest, underneath the sternum. The bar is flipped to a convex position so as to push outward on the sternum, correcting the deformity. The bar usually stays in the body for about two years, although many surgeons are now moving toward leaving them in for up to five years. When the bones have solidified into place, the bar is removed through outpatient surgery. Although initially designed to be performed in younger children (less than 10 years of age) whose sternum and cartilage is more flexible, there are successful series of Nuss treatment in patients well into their teens and twenties. The Nuss procedure is a two-stage procedure.
Robicsek technique.
In 1965, Francis Robicsek, based at Charlotte Memorial Hospital, now named Carolinas Medical Center in Charlotte, North Carolina, developed the Robicsek procedure. Each time the procedure is performed, it is individually tailored based on the extent and location of the deformity in the patient. The operation begins with an incision, no more than 4–6 centimeters, to the sternum. The pectoralis major muscles are then detached from the sternum. Using the upper limit of the sternal depression as a guide, the deformed cartilages are removed one-by-one, using sharp and blunt dissection. The lower tip of the sternum is then grabbed with a towel-clip and, using blunt dissection, is freed of tissue connections with the pericardium and the pleura. The sternum is then forcefully bent forward into a corrected position. To keep the sternum elevated, a piece of mesh is placed under the mobilized sternum and sutured under moderate tension bilaterally to the stumps of the ribs. The pectoralis muscles are united in front of the sternum and the wound is closed. The Robicsek procedure is a single-stage procedure (one surgery only).
The purported advantage of this technique is that it is less invasive than the Ravitch technique, but critics have suggested that the relapse rate may be high due to cartilage and bone displaying memory phenomenon.
Taulinoplasty.
In 2016, Carlos Bardají, a Barcelona-based pediatric surgeon, together with Lluís Cassou, a biomedical engineer, published a paper describing an extra-thoracic surgical procedure for the correction of pectus excavatum called taulinoplasty. A specially designed implant and traction hardware were developed specifically for the procedure.
In taulinoplasty, a small hole is drilled into the sternum at the deepest point of defect, and a double screw is driven into the hole. Then, a stainless steel implant is placed underneath the skin on top of the sternum and ribs, centered over the double screw. Traction tools are then used to lift the sternum up by the double screw using the implant and ribs for traction. Additional screws are then used to secure the implant onto the sternum holding the sternum in the desired position. Optionally, stainless steel wire may be wrapped around the implant and ribs to further secure the implant in place.
Like the Nuss procedure, taulinoplasty requires follow-up surgery several years later to remove the implanted hardware once the sternum has permanently assumed its new position.
The implant and related hardware used in taulinoplasty is a proprietary product of Ventura Medical Technologies and is marketed as a surgical kit under the brand name Pectus UP.
Taulinoplasty was developed to be an alternative to the Nuss procedure that eliminates the risks and drawbacks of entering the thorax. In particular, patients usually have shorter operating and recovery times, and less post-operative pain than with the Nuss procedure.
Plastic surgery.
Implants.
The implant allows pectus excavatum to be treated from a purely morphological perspective. Today it is used as a benchmark procedure as it is simple, reliable, and minimally intrusive while offering aesthetically-pleasing results. This procedure does not, however, claim to correct existing cardiac and respiratory problems which, in very rare cases, can be triggered by the pectus excavatum condition. For female sufferers, the potential resulting breast asymmetry can be partially or completely corrected by this procedure.
The process of creating a plaster-cast model, directly on the skin of the patient's thorax, can be used in the design of the implants. The evolution of medical imaging and CAD (computer-aided design) now allows customised 3D implants to be designed directly from the ribcage, therefore being much more precise, easier to place sub-pectorally and perfectly adapted to the shape of each patient. The implants are made of medical silicon rubber which is age-resistant and unbreakable (different to the silicon gel used in breast implants). They will last for life (apart from the case of adverse reactions) and are not visible externally.
The surgery is performed under general anesthesia and takes about an hour. The surgeon makes an incision of approximately seven centimetres, prepares the customised space in the chest, inserts the implant deep beneath the muscle, then closes the incision. Post-operative hospitalization is typically around three days.
The recovery after the surgery typically requires only mild pain relief. Post-operatively, a surgical dressing is required for several days and compression vest for a month following the procedure. A check-up appointment is carried out after a week for puncture of seroma. If the surgery has minimal complications, the patient can resume normal activities quickly, returning to work after 15 days and participating in any sporting activities after three months.
Lipofilling.
The "lipofilling" technique consists of sucking fat from the patient using a syringe with a large gauge needle (usually from the abdomen or the outer thighs), then after centrifugation, the fat cells are re-injected beneath the skin into whichever hollow it is needed to fill. This technique is primarily used to correct small defects which may persist after conventional surgical treatment.
Epidemiology.
Pectus excavatum occurs in an estimated 1 in 150 to 1 in 1000 births, with male predominance (male-to-female ratio of 3:1). In 35% to 45% of cases family members are affected.
Etymology.
Pectus excavatum is from Latin meaning "hollowed chest". It is sometimes referred to as sunken chest syndrome, cobbler's chest or funnel chest.
Society.
American Olympic swimmer Cody Miller (born 1992) opted not to have treatment for pectus excavatum, even though it limited his lung capacity. He earned a gold medal in 2016.
Actor Joel Kinnaman underwent surgery prior to the filming of "Altered Carbon", inserting two metal bars to push the sternum outward in order to correct the deformity.
YouTuber and streamer Ludwig Ahgren is known to have this condition.
In animals.
Pectus excavatum is also known to occur in animals, e.g. the Munchkin breed of cat. Some procedures used to treat the condition in animals have not been used in human treatments, such as the use of a cast with sutures wrapped around the sternum and the use of internal and external splints. These techniques are generally used in immature animals with flexible cartilage.


Edward G. Jones

Edward (Ted) G. Jones (March 26, 1939, Upper Hutt, New Zealand – June 6, 2011, Davis, California) was an American neuroscientist and a prolific neuroanatomist.
One of his main contributions involves his Matrix-Core theory of thalamic organization. He authored a highly influential book entitled "The Thalamus" in 1985. Jones resided in California and served as director for the Center for Neuroscience at the University of California, Davis.
He was a former president of the Society for Neuroscience.


Trabeculae of spleen

The fibroelastic coat of the spleen invests the organ, and at the hilum is reflected inward upon the vessels in the form of sheaths. From these sheaths, as well as from the inner surface of the fibroelastic coat, numerous small fibrous bands, the trabeculae of the spleen (or splenic trabeculae), emerge from all directions; these uniting, constitute the frame-work of the spleen.
The spleen therefore consists of a number of small spaces or areolae, formed by the trabeculae; in these areolae is contained the splenic pulp.


American Association of Immunologists

The American Association of Immunologists (AAI) is an international scientific society dedicated to furthering the study of immunology. AAI provides its members with a variety of platforms in which to exchange ideas and present the latest immunological research, including the AAI annual meeting and "The Journal of Immunology". In 2017, AAI launched an open-access journal, "ImmunoHorizons". AAI is a founding member society of the Federation of American Societies for Experimental Biology (FASEB).
Mission.
The American Association of Immunologists is an association of professionally trained scientists from all over the world dedicated to advancing the knowledge of immunology and its related disciplines, fostering the interchange of ideas and information among investigators, and addressing the potential integration of immunologic principles into clinical practice. AAI serves its members by providing a center for the dissemination of information relevant to the field and its practices, such as educational and professional opportunities, scientific meetings, membership-derived issues and opinions, and important social and political issues.
History.
The AAI was founded on June 19, 1913, in Minneapolis, Minnesota, by a group of physicians who were attending the annual meeting of the American Medical Association. The original 41 members of the society were all disciples of Almroth Wright, the founder and director of the Inoculation Department at St. Mary's Hospital in London. The first AAI annual meeting was held in Atlantic City, New Jersey, on June 22, 1914.
Governance.
AAI is led by a council of eight scientists who are elected by voting members of AAI. The council includes four officers—president, vice-president, secretary-treasurer, and past president—as well as four additional councilors.
Publications.
AAI is the publisher of "The Journal of Immunology" and "ImmunoHorizons". The association also publishes the bimonthly "AAI Newsletter", which informs members of developments in public policy, achievement of AAI members, meeting announcements, and other association news.
Membership.
AAI has 8,800 members in 65 countries. Its membership includes principal investigators, postdoctoral fellows, graduate students, administrators, and other professionals dedicated to furthering the study of immunology.
Nobel laureates.
Since 1919, 27 AAI members have been awarded the Nobel Prize. All laureates received the Nobel Prize in physiology or medicine, except where indicated.


Kabaddi Federation of Uganda

The Kabaddi Federation of Uganda (KFU) is the governing body of Kabaddi in Uganda.Kabaddi, is a contact sport, native to the Indian subcontinent.
The Kabaddi Federation of Uganda was founded in 2017 and its affiliated to International Kabaddi Federation since 2017. It organises both the men as well the women's national Kabaddi team and organises the Uganda Kabaddi League.
Location.
The Kabaddi Federation of Uganda headquarters is located on Plot 12/16, Mapeera road, Nalukolongo, Rubaga Division in Kampala District.
Organisation.
In February 2019, the National Council Of Uganda certified the Kabaddi Federation of Uganda as one of the sports in the country.
Competition.
In November 2019, Uganda Kabaddi team competited in the Junior World Kabaddi Championship which took place in Iran.


Terry Thomas sign

In radiology, the Terry Thomas sign is a scapholunate ligament dissociation on an anteroposterior view of the wrist. Most commonly a result of a fall on the outstretched hand (), the scapholunate ligament ruptures resulting in separation of the lunate and scaphoid bones. This burst causes the scaphoid bone to dorsally rotate. A gap of more than 3mm is pathognomonic for scapholunate dissociation.
The resulting separation between the scaphoid and lunate bones leaves a space on the x-ray that is similar to the gap comedian Terry-Thomas had between his front teeth. For newer radiology students who do not know who Terry-Thomas was, this finding might also be known as the David Letterman sign.


Nephronophthisis

Nephronophthisis is a genetic disorder of the kidneys which affects children. It is classified as a medullary cystic kidney disease. The disorder is inherited in an autosomal recessive fashion and, although rare, is the most common genetic cause of childhood kidney failure. It is a form of ciliopathy. Its incidence has been estimated to be 0.9 cases per million people in the United States, and 1 in 50,000 births in Canada.
Signs and symptoms.
Infantile, juvenile, and adolescent forms of nephronophthisis have been identified. Although the range of characterizations is broad, people affected by nephronophthisis typically present with polyuria (production of a large volume of urine), polydipsia (excessive liquid intake), and after several months to years, end-stage kidney disease, a condition necessitating either dialysis or a kidney transplant in order to survive. Some individuals that suffer from nephronophthisis also have so-called "extra-renal symptoms" which can include tapetoretinal degeneration, liver problems, ocularmotor apraxia, and cone-shaped epiphysis (Saldino-Mainzer syndrome).
Cause.
Nephronophthisis is characterized by fibrosis and the formation of cysts at the cortico-medullary junction, it is an autosomal recessive disorder which eventually leads to terminal kidney failure.
Pathophysiology.
Mechanism of nephronophthisis indicates that all proteins mutated in cystic kidney diseases express themselves in primary cilia. NPHP gene mutations cause defects in signaling resulting in flaws of planar cell polarity. The ciliary theory indicates that multiple organs are involved in NPHP (retinal degeneration, cerebellar hypoplasia, liver fibrosis, and intellectual disability).
Related rare genetic disorders.
Nephronophthisis is a ciliopathy. Other known ciliopathies include primary ciliary dyskinesia, Bardet–Biedl syndrome, polycystic kidney and liver disease, Alström syndrome, Meckel–Gruber syndrome and some forms of retinal degeneration.
NPHP2 is infantile type of nephropthisis and sometimes associated with situs inversus this can be explained by its relation with inversin gene. NPHP1, NPHP3, NPHP4, NPHP5, and NPHP6 are sometimes seen with retinitis pigmentosa, this particular association has a name, Senior-Loken syndrome.
Diagnosis.
The diagnosis of nephronophthisis can be obtained via a kidney ultrasound, family history and clinical history of the affected individual according to Stockman, et al.
Management.
The management of this condition can be done via-improvement of any electrolyte imbalance, as well as, high blood pressure and low red blood cell counts (anemia) treatment as the individual's condition warrants.
Epidemiology.
Nephronophthisis occurs equally in both sexes and has an estimate 9 in about 8 million rate in individuals. Nephronophthisis is the leading monogenic cause of end-stage kidney disease.


Gaspard Laurent Bayle

Gaspard Laurent Bayle (18 August 1774, Le Vernet, Alpes-de-Haute-Provence – 1816) was a French physician.
He studied medicine under Jean-Nicolas Corvisart (1755–1821), and was a colleague to René Laennec (1781–1826). Beginning in 1805 he practiced medicine at the Hôpital de la Charité in Paris. He was an uncle to physician Antoine Laurent Bayle (1799–1859).
Bayle is remembered for his extensive work in pathological anatomy, making contributions in research of cancer and tuberculosis. As the result of 900 post-mortem investigations, he described six different types of tuberculosis — ulcerous phthisis, calculous phthisis, cancerous phthisis, tubercular phthisis, glandular phthisis and phthisis with melanosis.
His best known written effort was the 1810 "Recherches sur la phthisie pulmonaire" (Research of pulmonary tuberculosis). He also penned a treatise on cancerous diseases that was published posthumously (1833) by his nephew, Antoine Laurent Bayle.


American Institute for Cancer Research

The American Institute for Cancer Research (AICR) is a large American cancer research organization associated with the World Cancer Research Fund umbrella organization.
As of 2018, the charity has a "one star" rating from Charity Navigator, with a score of 62.81 out of 100. At the time of their rating, over 45% of the charity's income turned around into fundraising expenses. For the fiscal year ending September 2018, the organization had annual revenues of $15.5 million.


Arthrology

Arthrology is the science concerned with the study of anatomy, function, dysfunction and treatment of joints and articulations.
The prefix "arthro-" refers to joints, as in arthrogram, arthroscopy, or arthritis, from the Greek ἄρθρον "arthron". Arthrology is also called as arthrologia, syndesmologia, syndesmology, and synosteology. Specialists in this filed are known as arthrologists.


Ronald Bukowski

Ronald M. Bukowski is an American oncologist, urologist, and a professor of medicine who have more than 1000 peer-reviewed articles.
Biography.
Bukowski received his MD from Northwestern University Medical School. From 2001 to 2008 he was a chairman at the Taussig Cancer Center and then decided to retire from being one. In the past he was a fellow of the American College of Physicians and was a member of such well-known societies as both the American Society of Clinical Oncology, American Society of Hematology and the Southwest Oncology Group. His articles were published in such journals as the International Journal of Cancer and New England Journal of Medicine among others. From 2004 to 2008 he served on Oncology Drug Advisory Committee where he still works and is currently works as an emeritus staff member at the Cleveland Clinic Lerner College of Medicine at the Case Western Reserve University.


American Pain Society

The American Pain Society (APS) was a professional membership organization and a national chapter of the International Association for the Study of Pain (IASP). Disciplines represented include medicine, dentistry, psychology, nursing, physical therapy, pharmacy, basic science, government, law, business and industry. Regular, affiliate, student/trainee, and corporate memberships are available.
Bankruptcy.
On June 28, 2019, the APS commenced a Chapter 7 bankruptcy in the United States Bankruptcy Court for the Northern District of Illinois. This followed a vote by the membership, followed by a vote by the board of directors. The APS claimed that the reason for the bankruptcy was the numerous legal expenses which resulted from lawsuits claiming the organization was acting as a front group for opioid drugmakers.
"Publications".
The society's official journal is known as The Journal of Pain, which is published by Elsevier. The fate of the journal in the wake of the bankruptcy is unclear.


Iliopubic eminence

Medial to the anterior inferior iliac spine is a broad, shallow groove, over which the iliacus and psoas major muscles pass. This groove is bounded medially by an eminence, the iliopubic eminence (or iliopectineal eminence), which marks the point of union of the ilium and pubis.
It constitutes a lateral border of the pelvic inlet.
The iliopectineal line is the border of the eminence.
The psoas minor, when present, inserts at the pectineal line of the eminence.


Andrew Mlangeni

Andrew Mokete Mlangeni (6 June 192521 July 2020), also known as Percy Mokoena, Mokete Mokoena, and Rev. Mokete Mokoena, was a South African political activist and anti-apartheid campaigner who, along with Nelson Mandela and others, was imprisoned after the Rivonia Trial.
Early life.
Mlangeni was born in Bethlehem, Orange Free State. After having to give up his studies owing to poverty, after 1946 he experienced worker exploitation as a factory worker. When working as a bus driver, he was active in a strike for better working conditions and a living wage, and in 1951, joined the African National Congress Youth League (ANCYL). In 1954, he joined the African National Congress (ANC). In 1961, he was sent for military training outside the country, but on his return in 1963 was arrested, after being accused of recruiting and training an armed force. He was found guilty in the Rivonia Trial and sentenced to life imprisonment on Robben Island, where he was Prisoner 467/64.
Later life.
Mlangeni was released from prison in October 1989 after having served 26 years of his life sentence. Mlangeni served as a member of parliament for the ANC from 1994 to 1999. He served once more in the National Assembly from 2009 to 2014, when he retired. He was close friends with Nelson Mandela and spoke at Mandela's memorial service at FNB Stadium.
In 2015, director Lebogang Rasethaba made a film about Mlangeni, "Prisoner 467/64: The Untold Legacy of Andrew Mlangeni".
In 2017, Mlangeni appeared with fellow defendants at the Rivonia Trial, Denis Goldberg and Ahmed Kathrada, along with lawyers Joel Joffe, George Bizos and Denis Kuny in a documentary film entitled "Life is Wonderful", directed by Sir Nicholas Stadlen, which tells the story of the trial. (The title reflects Goldberg's words to his mother at the end of the trial on hearing that he and his comrades had been spared the death sentence).
On 26 April 2018, Mlangeni received an Honorary Doctorate in Education from the Durban University of Technology in South Africa. He was also awarded an honorary doctorate in Law on 7 April 2018 by Rhodes University.
Mlangeni was awarded the Freedom of the City of London on 20 July 2018 at age 93. On that visit, he was also a guest of honour at the opening of the Mandela Centenary Exhibition at the South Bank Centre, alongside the Duke and Duchess of Sussex. On the Centenary Celebration of Nelson Mandela's birth, he also read Mandela's favourite poem – Invictus – which was aired on the BBC's "Newsnight" programme.
Personal life.
He married June Ledwaba (22 March 1927 – 24 May 2001) from 1950 until her death in 2001 from cancer. The couple had four children.
Death.
Mlangeni died on 21 July 2020 in 1 Military Hospital in Pretoria after complaining of abdominal related issues. He was 95 and was the last surviving Rivonia Trialist following the death of Denis Goldberg on 29 April same year. President Cyril Ramaphosa expressed his condolences on behalf of the government, stating: "The passing of Andrew Mokete Mlangeni signifies the end of a generational history and places our future squarely in our hands".<br> He was given a special state funeral on 29 July 2020 and he was buried at Roodepoort cemetery next to his wife June.


Humoral immunity

Humoral immunity or humoural immunity is the aspect of immunity that is mediated by macromolecules found in extracellular fluids such as secreted antibodies, complement proteins, and certain antimicrobial peptides. Humoral immunity is named so because it involves substances found in the humors, or body fluids. It contrasts with cell-mediated immunity. Humoral immunity is also referred to as antibody-mediated immunity.
The study of the molecular and cellular components that form the immune system, including their function and interaction, is the central science of immunology. The immune system is divided into a more primitive innate immune system and an acquired or adaptive immune system of vertebrates, each of which contain both humoral and cellular immune elements.
Humoral immunity refers to antibody production and the coinciding processes that accompany it, including: Th2 activation and cytokine production, germinal center formation and isotype switching, and affinity maturation and memory cell generation. It also refers to the effector functions of antibodies, which include pathogen and toxin neutralization, classical complement activation, and opsonin promotion of phagocytosis and pathogen elimination.
History.
The concept of humoral immunity developed based on the analysis of antibacterial activity of the serum components. Hans Buchner is credited with the development of the humoral theory. In 1890, Buchner described alexins as "protective substances" that exist in the blood serum and other bodily fluids and are capable of killing microorganisms. Alexins, later redefined as "complements" by Paul Ehrlich, were shown to be the soluble components of the innate response that leads to a combination of cellular and humoral immunity. This discovery helped to bridge the features of innate and acquired immunity.
Following the 1888 discovery of the bacteria that cause diphtheria and tetanus, Emil von Behring and Kitasato Shibasaburō showed that disease need not be caused by microorganisms themselves. They discovered that cell-free filtrates were sufficient to cause disease. In 1890, filtrates of diphtheria, later named diphtheria toxins, were used to vaccinate animals in an attempt to demonstrate that immunized serum contained an antitoxin that could neutralize the activity of the toxin and could transfer immunity to non-immune animals. In 1897, Paul Ehrlich showed that antibodies form against the plant toxins ricin and abrin, and proposed that these antibodies are responsible for immunity. Ehrlich, with his colleague von Behring, went on to develop the diphtheria antitoxin, which became the first major success of modern immunotherapy. The discovery of specified compatible antibodies became a major tool in the standardization of immunity and the identification of lingering infections.
Antibodies.
Immunoglobulins are glycoproteins in the immunoglobulin superfamily that function as antibodies. The terms "antibody" and "immunoglobulin" are often used interchangeably. They are found in the blood and tissue fluids, as well as many secretions. In structure, they are large Y-shaped globular proteins. In mammals there are five types of antibody: IgA, IgD, IgE, IgG, and IgM. Each immunoglobulin class differs in its biological properties and has evolved to deal with different antigens. Antibodies are synthesized and secreted by plasma cells that are derived from the B cells of the immune system.
An antibody is used by the acquired immune system to identify and neutralize foreign objects like bacteria and viruses. Each antibody recognizes a specific antigen unique to its target. By binding their specific antigens, antibodies can cause agglutination and precipitation of antibody-antigen products, prime for phagocytosis by macrophages and other cells, block viral receptors, and stimulate other immune responses, such as the complement pathway.
An incompatible blood transfusion causes a transfusion reaction, which is mediated by the humoral immune response. This type of reaction, called an acute hemolytic reaction, results in the rapid destruction (hemolysis) of the donor red blood cells by host antibodies. The cause is usually a clerical error, such as the wrong unit of blood being given to the wrong patient. The symptoms are fever and chills, sometimes with back pain and pink or red urine (hemoglobinuria). The major complication is that hemoglobin released by the destruction of red blood cells can cause acute kidney failure.
Antibody production.
In humoral immune response, the B cells first mature in the bone marrow and gain B-cell receptors (BCR's) which are displayed in large numbers on the cell surface.
These membrane-bound protein complexes have antibodies which are specific for antigen detection. Each B cell has a unique antibody that binds with an antigen. The mature B cells then migrate from the bone marrow to the lymph nodes or other lymphatic organs, where they begin to encounter pathogens.
B cell activation.
When a B cell encounters an antigen, the antigen binds to the receptor and is taken inside the B cell by endocytosis. The antigen is processed and presented on the B cell's surface again by MHC-II proteins.
B cell proliferation.
The B cell waits for a helper T cell (TH) to bind to the complex. This binding will activate the TH cell, which then releases cytokines that induce B cells to divide rapidly, making thousands of identical clones of the B cell. These daughter cells either become plasma cells or memory cells. The memory B cells remain inactive here; later, when these memory B cells encounter the same antigen due to reinfection, they divide and form plasma cells. On the other hand, the plasma cells produce a large number of antibodies which are released freely into the circulatory system.
Antibody-antigen reaction.
These antibodies will encounter antigens and bind with them. This will either interfere with the chemical interaction between host and foreign cells, or they may form bridges between their antigenic sites hindering their proper functioning. Their presence might also attract macrophages or killer cells to attack and phagocytose them.
Complement system.
The complement system is a biochemical cascade of the innate immune system that helps clear pathogens from an organism. It is derived from many small blood plasma proteins that work together to disrupt the target cell's plasma membrane leading to cytolysis of the cell. The complement system consists of more than 35 soluble and cell-bound proteins, 12 of which are directly involved in the complement pathways. The complement system is involved in the activities of both innate immunity and acquired immunity.
Activation of this system leads to cytolysis, chemotaxis, opsonization, immune clearance, and inflammation, as well as the marking of pathogens for phagocytosis. The proteins account for 5% of the serum globulin fraction. Most of these proteins circulate as zymogens, which are inactive until proteolytic cleavage.
Three biochemical pathways activate the complement system: the classical complement pathway, the alternate complement pathway, and the mannose-binding lectin pathway. The classical complement pathway typically requires antibodies for activation and is a specific immune response, while the alternate pathway can be activated without the presence of antibodies and is considered a non-specific immune response. Antibodies, in particular the IgG1 class, can also "fix" complement.


Harry Raymond Eastlack

Harry Raymond Eastlack, Jr. (17 November 1933 – 11 November 1973) was the subject of the most recognized case of FOP (fibrodysplasia ossificans progressiva) from the 20th Century. His case is also particularly acknowledged, by scientists and researchers, for his contribution to medical advancement. After suffering from a rare, disabling, and currently incurable genetic disease, Eastlack decided to have his skeleton and medical history donated to the Mütter Museum of the College of Physicians of Philadelphia in support of FOP research. His skeleton is one of the few FOP-presenting, fully articulated ones in existence, and it has proved valuable to the study of the disease.
As is characteristic of FOP patients, Eastlack did not demonstrate any possible sign of a disease at birth except for a malformation of the big toes. At the time it was not recognized as the first clinical sign of FOP. It was not until 1937 when the first Heterotopic ossification symptom surfaced. By the time of his death, Eastlack's skeleton bore sheets of bone along the vertebrae, which fused to and locked his skull, and branches of bone along his limbs, which immobilized his shoulders, elbows, hips, and knees. He died in Philadelphia of bronchial pneumonia six days before his 40th birthday.
Early life.
Birth.
Harry Eastlack was born on November 17, 1933 at 10:24 AM in the Woman's Hospital of Philadelphia. There are no reports of any difficulties during his delivery, though there was the observation of a minor congenital malformation. The noted malformation was his congenital bilateral hallux valgus, oftentimes referred to as a bunion.
Family.
Harry Raymond Eastlack, Jr. was son to Helen Florence Brown and Harry Raymond Eastlack. They were both 40 years of age at the time of his birth. His father, Harry, worked in the railroads under engineering management, while his mother was a housewife. They resided in 5745 Haddington Street, Philadelphia, Pennsylvania, and at the time of Harry's birth they already had a daughter by the name of Helene. Harry was closest to his mother, Helen. She would walk him to and from school, as well as bake for him at home. His sister, Helene, later became a music teacher and remained in Philadelphia.
Childhood.
Records suggest that his childhood was an active and happy one. His pastimes consisted of listening to music on the radio or records at home. Eastlack would also enjoy reading, playing with his sister, and going to the movies. Additionally, a seat was exclusively reserved for him at the center of the seventh row in Hamilton Theater, a musical theater, in Philadelphia. It has been claimed that ushers would not let anyone else sit there, as the spot was spacious enough to later allow Eastlack to stretch his immobile leg.
Diagnosis.
While heterotopic bone growth can begin spontaneously in FOP patients, Eastlack, like most patients, first experienced a triggered proliferation due to an illness or injury. He was about four years old, playing with Helene, his sister, outdoors. A car hit his leg, injuring his left femur. He was taken to the hospital where his leg was put in a cast before returning home. The fracture never set properly, and when the cast was removed months later, his leg was painfully swollen with a high amount of inflammation. No further action was taken and shortly after Eastlack begun to experience his first set of abnormal bone growths. His hips and knees had become difficult to move. When he was taken to the hospital with this concern, the doctor took X- rays in which the bony deposits on his thigh muscles were revealed. The doctors were not able to diagnose his condition having seen this, and it continued to progress in the anatomically characteristic manner that FOP does. Eastlack soon suffered flare- ups along his back, neck, and chest.
In attempts to diagnose and treat Eastlack's condition, the doctors ordered biopsies and performed a total of 11 surgical procedures to remove excess and heterotopic ossification, such as that on his thigh muscles. However, Eastlack's condition was aggravated by such procedures and the bone plates returned thicker and more predominant. It was 1938, the following year after the incident, when he was finally diagnosed with Myositis ossificans progressiva, which is now known as Fibrodysplasia Ossificans Progressiva (FOP).
Later life and FOP progression.
Unaware of the consequences of surgery on an FOP patient, the physician admitted Eastlack for hip surgery in 1941 which caused further physical restriction. Over time Eastlack became more and more immobilized as more joints became fused and newly formed sheets or strings of bone calcified his limbs. In 1944 he was readmitted for a study which confirmed that the calcified smooth muscles, tendons, and ligaments had indeed become mature bone. The ossification along his vertebrae and other anatomical parts that Eastlack would suffer in the next 29 years ultimately fused him into an eternally bowed position.
Eastlack's case of FOP progressed at a more rapid rate due to the number of intrusive surgeries he underwent. In 1948, at the age of 15, his jaw had become fused so he could no longer eat solid food and had to speak through clenched teeth. At a young age he faced difficulty sitting down, as well. His hips were one of the first anatomical parts to become immobilized due to heterotopic ossification. Soon, bone formed across his upper arms and extended onto his sternum, tying his arms to his breast. Sheets of bone spread along his back and ribbons of bone extended from there to his skull, inhibiting proper head movement. The new bone growths throughout the years also caused juts of bone to form on his pelvis and thighs, and it caused both of his feet to become clubbed. One year he accidentally bumped his buttocks into a radiator, and this resulted in a bruise wherein the smooth tissue was destroyed and gave way to newly formed bone. Ultimately, the only mobility that Eastlack had left was that of his eyes, lips, and tongue.
As the disease progressed, Eastlack struggled more with routine movement and self-care. At first it was his mother, Helen, who would assist and care for him. However, by the time Eastlack reached about 20 years old, his mother was too feeble to continue. He was then taken to a nursing home in Philadelphia, The Inglis House for the Incurables, which is now simply known as the Inglis House.
Death.
Eastlack died at the Inglis House for the Incurables—a care home dedicated to attending low income, physically disabled individuals. As he approached the later stages of his life, he required assistance to stand and used a cane to be able to shuffle. During his time there, his right leg broke and is said to have healed at an odd angle. Consequently, he spent years bedridden and developed Bronchial Pneumonia from the physical inactivity. Due to the ossification on his ribs, his lungs could not expand well and this inhibited his ability to cough. Near the time of his death, Eastlack told his sister, Helene, that he desired to donate his body and medical records to research, so that the disease may be further investigated and understood. On November 11 1973, just six days shy of his 40th birthday, he died of pneumonia.
Medical contributions.
Eastlack's home, Philadelphia, has become a center for FOP research with much of it concentrated at the University of Pennsylvania. With his skeleton on display, doctors and professors alike lead students to the Mütter Museum to observe the result of the rare disorder in person. Since surgeries and examinations of FOP patients exacerbate the condition, the ability to study Eastlack's skeleton has been significant for research. For example, in 2006, University of Pennsylvania's team of researchers and scientists led by Frederick Kaplan was able to distinguish the particular gene responsible for the disease, the ACVR1 gene. It is said that Eastlack's skeleton was a useful reference for this medical discovery. The International FOP Association is also granted Eastlack's skeleton for displaying and informational purposes in medical meetings and international FOP symposia, which physicians, researchers, and patients attend. For example, over 43 families were recorded to have attended a two- day symposium hosted in Philadelphia on October 1995 to listen to orthopedic surgeons and physicians discuss the details of FOP. During this symposium, Eastlack's skeleton was used as a reference. After seeing his skeleton at this event, fellow FOP patient Carol Orzel decided to also donate her body to the museum. She died in February 2018, and in February 2019, her skeleton was put on display next to his.
Mentions in culture.
In the 2009 film inspired by Edgar Allan Poe's "The Tell-Tale Heart", "Tell-Tale", Eastlack is mentioned and referred to as Harry Erlich. The mention occurs in a scene where characters are in a museum, and a skeleton is referred to. The scene provides some genuine facts, such as how Eastlack's skeleton does not require any wiring or glue to be held together in the museum because the fused bones hold it all in one piece.


Alfred Bannwarth

Alfred Bannwarth (1903 – 1970) was a German neurologist who is credited for first reporting lymphocytic meningoradiculitis.
Biography.
Early life and education.
After first studying music, Bannwarth studied medicine in Munich, Germany, and later became an assistant to German neurologist Max Nonne in Hamburg.
Military service.
Bannwarth enlisted as a military doctor in the German military in 1945. During his service, he was stationed in the valley of Lake Tegern, where he was captured by American soldiers and held prisoner until June 1946.


International Aikido Federation

International Aikido Federation (International Aikido Federation) is a world governing body for the sport of Aikido.
Structure.
The International Aikido Federation was formed in 1976 to serve as a primary global aikido organisation. It is an umbrella organisation with member organisations from more than 40 nations (for example, the All-Japan Aikido Federation is one member). All members must be recognised by the Hombu, so the IAF exclusively represents the Aikikai school. The IAF is a nominally democratic organisation but special roles are given to the Doshu and a council of senior instructors, to safeguard the "technical and moral" integrity of aikido. The IAF currently admits only one member organisation per country and gives each such member equal vote (it was modeled on the UN; it does not necessarily give every Aikikai student equal representation).
The IAF demonstrates aikido at the World Games, and represents aikido to the globe. The IAF also organises International Aikido Congresses every four years, facilitating direct training between aikido students of different countries, sharing instruction by the world's most senior aikido instructors, and also providing a channel for official communication with the Hombu.
The IAF publishes a list of member nations and organisations.
Chairs.
Peter Goldsbury is also a Professor of comparative mythology at Hiroshima and he has published a large body of aikido articles over his many years of practice. In early 2016, Peter Goldsbury announced his retirement and he officially stepped down following the elections that took place during the 12th IAF Congress held in September 2016 in the city of Takasaki (Gunma Prefecture, Japan).
Kei Izawa previously served as the IAF's General Secretary and he has also the translated in English the biography of Morihei Ueshiba written by his son, Kisshomaru Ueshiba.
Events.
International Aikido Federation Congress.
Every four years, the IAF holds a Congress in Japan where delegations from all member countries gather for a week of practice under the direction of numerous high ranked instructors, both Japanese and foreign. Along the seminar are held directing committee meetings as well as elections. The last congress took place in the city of Takasaki (Gunma) in September 2016.
Other Events.
The IAF was represented at both of SportAccord's World Combat Games that took place in China and Russia in 2010 and 2013, respectively.


Chitturi Satyanarayana

Doctor Satyanarayana (6 October 1913 – 19 April 2012) was an eminent Indian ENT surgeon who had served the post of the honorary surgeon to the President of India.


Carol Orzel

Carol Orzel (April 20, 1959 - February 2018) was an American woman with fibrodysplasia ossificans progressiva (FOP). She advocated for research into FOP and was an activist for disability rights. Before her death, she requested that her skeleton be displayed in the Mütter Museum.
Early life.
Orzel was born in Philadelphia in 1959 and diagnosed with FOP, a rare disease that causes tissue to ossify. In 1982 at age 23, she moved to Inglis House, a nursing-care facility, at its Belmont Avenue campus.
Advocacy and association with University of Pennsylvania.
After moving to Inglis House, Orzel became a patient of doctor Frederick Kaplan at the University of Pennsylvania. Kaplan had never before met someone with FOP, and the disease would become his focus. Orzel gave annual talks to incoming medical students at University of Pennsylvania to help them better understand treating people with disabilities. The Mütter Museum notes that she "advocated for more research, established networks of communication with others with FOP, and educated both the public and medical professionals about the disease." She was involved in the International FOP Association, or IFOPA, and cut the ribbon at the opening of UPenn's FOP Research Laboratory. It was this laboratory where the gene that causes FOP was discovered in 2006.
Donation of skeleton to Mütter Museum.
In 1995, Orzel saw the skeleton of Harry Eastlack, a famous patient of FOP, at a IFOPA conference. The skeleton was on loan from the Mütter Museum, and Orzel decided that after she died, she wanted her skeleton to be displayed with Eastlack's, on the condition that her jewelry was displayed too. When Orzel died at the Hospital of the University of Pennsylvania in 2018, Kaplan and executives from Inglis House contacted the Mütter Museum. Curator Anna Dhody oversaw the project. Due to the FOP and other illness, Orzel's body was very delicate and difficult to transport and prepare. Her body was transported from Philadelphia to Skulls Unlimited in Oklahoma City for processing. Orzel's skeleton and her jewelry went on display in the Mütter Museum in February 2019.


Neel Burton

Neel Burton (born 3 June 1978 in Mauritius, Indian Ocean) is a British psychiatrist, philosopher, writer, and educator. He is the author of several books, including "Psychiatry" (2006), "Living with Schizophrenia" (2007), "The Meaning of Madness" (2008), "Master your Mind" (2009), "Heaven and Hell: The Psychology of the Emotions" (2015), and "Hypersanity: Thinking Beyond Thinking" (2019).


Costoxiphoid ligaments

The Costoxiphoid Ligaments (chondroxiphoid ligaments) are inconstant strand-like fibrous bands that connect the anterior and posterior surfaces of the seventh costal cartilage, and sometimes those of the sixth, to the front and back of the xiphoid process the sternum.
They vary in length and breadth in different subjects; those on the back of the joint are less distinct than those in front.


Congenital dermal melanocytosis


Carl Anton Ewald

Carl Anton Ewald (30 October 1845 – 20 September 1915) was a German gastroenterologist who was a native of Berlin. He was the brother of physiologist Ernst Julius Richard Ewald (1855–1921).
In 1870 he earned his medical doctorate in Berlin, and subsequently became an assistant to pathologist Friedrich Theodor von Frerichs (1819–1885). In 1888 he was appointed head physician of the department of internal medicine at Augusta Hospital in Berlin.
Carl Ewald was a pioneer in the field of gastroenterology, and was a catalyst in making Augusta Hospital a center for pathological studies of digestion. Ewald is remembered for investigations of gastric secretions, and the introduction of intubation as a medical aid in gastric analysis. The eponymous "Ewald tube" is named after him, a device that serves as a gastric tube for emptying the contents of the stomach.
With Ismar Isidor Boas (1858–1938), he developed a standard "test meal" for gastric analysis. This involved a process in which various foods were given to a patient, and followed by analysis of gastric juices at scheduled intervals.
Among his published works are "The Diseases of the Stomach" and "Lectures on Digestion", two books that have been translated into English. For many years he was editor of the "Berlin klinische Wochenschrift". He also served as librarian to the Berlin Medical Society.


Mongolian spot

Slate grey nevus (congenital dermal melanocytosis, Mongolian spot) is a benign, flat, congenital birthmark, with wavy borders and an irregular shape. In 1883, it was described and named after Mongolians by Erwin Bälz, a German anthropologist based in Japan, who erroneously believed it to be most prevalent among his Mongolian patients. It normally disappears three to five years after birth and almost always by puberty. The most common color is blue, although they can be blue-gray, blue-black or deep brown.
Cause.
Slate grey nevus is a congenital developmental condition—that is, one existing from birth—exclusively involving the skin. The blue colour is caused by melanocytes, melanin-containing cells, that are usually located in the surface of the skin (the epidermis), but are in the deeper region (the dermis) in the location of the spot. Usually, as multiple spots or one large patch, it covers one or more of the lumbosacral area (lower back), the buttocks, sides, and shoulders. It results from the entrapment of melanocytes in the lower half to two-thirds of the dermis during their migration from the neural crest to the epidermis during embryonic development.
Male and female infants are equally predisposed to slate grey nevus.
People who are not aware of the background of the slate grey nevus may mistake them for bruises, possibly resulting in mistaken concerns about abuse.
Anthropological description.
The French anthropologist interested himself in what he called the "tache pigmentaire congenitale" or coloured birthmark, publishing multiple papers in the "Journal de la Société des Américanistes", an academic journal covering the cultural anthropology of the Americas. Gessain spent time with the Huehuetla Tepehua people in Hidalgo, Mexico, and wrote in 1947 about the spot's "location, shape, colour, histology, chemistry, genetic transmission, and racial distribution". He had previously spent several winters in Greenland, and wrote an overview in 1953 of what was known about the spot. He hypothesised that the age at which it faded in various populations might prove to be a distinguishing characteristic of those groups. Gessain claimed that the spot was first observed amongst the Inuit.
Hans Egede Saabye, a Danish priest and botanist, spent 1770–1778 in Greenland. His diaries, published in 1816 and translated into several European languages, contained much ethnographic information. He described the spot on newborns, saying he had seen it often when the infants were presented naked for baptism. A second Danish observer was doctor and zoologist Daniel Frederik Eschricht, mainly based in Copenhagen. In 1849 he wrote of the "mixed" babies he had delivered at the lying-in hospital. He also says that "the observation made for the first time by Saabye about Inuit children has been completely confirmed by Captain Holbøll", who sent him a fetus pickled in alcohol.
Gessain goes on to state that it was only in 1883 that an anthropologist mentions the spot. It was Erwin Bälz, a German working in Tokyo, who described a dark blue mark on Japanese infants. He presented his findings in 1901 in Berlin, and from that point on, Bälz's name was associated with certain skin cells containing pigment. Captain Gustav Frederik Holm wrote in 1887 that his Greenlandic interpreter Johannes Hansen (known as Hanserak) attested to the existence of the birthmark over the kidney region of newborns, which grows larger as they grow older. That year, the Danish anthropologist Soren Hansen drew the connection between the observations of Bälz in Japan and Saabye in Greenland. "This cannot be a coincidence. It is not the first time that the resemblance between the Japanese and the Eskimo has been pointed out." Fridtjof Nansen, the Norwegian polar explorer, said that the spot was widespread in the mixed Danish-Inuit population of West Greenland. Soren Hansen confirmed this. A missionary in Bethel, Alaska, a traditional gathering place of Yup'ik people, reported that the spots were common on children. , an Austrian linguist and ethnologist, spent the summer of 1906 on the West Coast of Greenland, and listed all the examples he came across. Gessain went to north Labrador in 1926, looking for children with these spots. In 1953 Dr Saxtorph, medical advisor to the Greenland department (part of the Danish government), wrote that the Greenlanders do not like outsiders to see or discuss these birthmarks; "they doubtless feel as a reminiscence of the time when they lived on a low cultural level".
The presence or absence of the slate grey nevus was used by racial theorists such as Joseph Deniker (1852-1918), the French anthropologist.
The "Journal of Cutaneous Diseases Including Syphilis, Volume 23" contained several accounts of the slate grey nevus on children in the Americas:
In Central America, according to these authorities, the spot is called "Uits," "pan," and it is an insult to speak of it. It disappears in the tenth month. It is bluish-reddish (in these Native people), and is remarkable by its small size. The mulberry colored spot is very well known in Afro-Brazilians. In Brazil, among individuals of mixed Indigenous American and West African descent (pardo) it is called "genipapo", from its resemblance in color (bluish-gray) to an indigenous fruit of Brazil, named genipapo (a Native word adopted into Portuguese).
Prevalence.
Infants may be born with one or more slate grey nevus ranging from small area on the buttocks to a larger area on the back. The birthmark is prevalent among East, South, Southeast, North and Central Asian peoples, Indigenous Oceanians (chiefly Micronesians and Polynesians), certain populations in Africa, Amerindians, non-European Latin Americans and Caribbeans of mixed-race descent.
They occur in around 80% of Asians, and 80% to 85% of Native American infants. Approximately 90% of Polynesians and Micronesians are born with slate grey nevus, as are about 46% of children in Latin America, where they are associated with non-European descent. These spots also appear on 5–10% of babies of full Caucasian descent; Coria del Río in Spain has a high incidence due to the presence of descendants of members of the delegation led by Hasekura Tsunenaga, the first Japanese official envoy to Spain in the early 17th century. African American babies have slate grey nevus at a frequencies of 90% to 96%.
According to a 2006 study examining the Mongolian spot among newborns in the Turkish city of İzmir, it was found out that 26% of the examined babies had the condition. It was noted the prevalence rate was 20% and 31% in boys and girls, respectively. The study also reported that no children born with light hair had the mark, meanwhile 47% of the children with dark hair having it.
Since the last century, extensive research has been made regarding the prevalence of said spot in populations of mixed European-Amerindian ancestry. A publication from 1905, citing field research made by the anthropologist Frederick Starr, states that the spot is not present in Mestizo populations, however, if Starr's actual research is consulted it is observed the he declares that "seven Mayan children presented the spot, three mixed children didn't have it...", Starr therefore does not make an absolute judgement, as he does not say how many mixed children were analyzed in total. Nowadays it is completely accepted that the big majority of Mexico's and Latin America's mixed-race populations have the Mongolian spot and that its presence works as an indicator of the actual degree of mestizaje present in a given population, having its lower frequency in Uruguay with 36%, followed by Argentina with an incidence 44%, Mexico with 50%-52%, 68% on Hispanic-Americans and 88% on highland Peruvians.
A study performed in hospitals of Mexico City reported that, on average, 51.8% of Mexican newborns presented slate grey nevus, while it was absent on 48.2% of the analyzed babies. According to the Mexican Social Security Institute nationwide, around half of Mexican babies have the slate grey nevus.
Central American indigenous children were subjected to racism due to their slate grey nevus but progressive circles began to make having the slate grey nevus popular after the late 1960s.
Highland Peruvians have the slate grey nevus.
Treatment.
As a congenital benign nevus, Mongolian spots do not require treatment and in most cases disappear before adolescence. No cases of malignant degeneration have been reported.
Cultural terminology.
The slate grey nevus is referred to in the Japanese idiom "shiri ga aoi" (), meaning "to have a blue butt", which is a reference to immaturity or inexperience.
In Mongolian Language, it is known as "Хөх толбо".
Korean mythology explains the nevus as a bruise formed when Samshin halmi or Samsin Halmoni (), a shaman spirit to whom people pray around childbirth, slapped the baby's behind to hasten the baby to quickly get out from his or her mother's womb.
In Chinese, it is referred to as "青痕" (Pinyin: Qīng Hén; Literally: Blue Mark). Among common folk it is said to be caused by the Buddhist goddess of childbirth Songzi Guanyin (Simplified Chinese: 送子观音; Pinyin: Sòng Zǐ Guān Yīn; Literally: The Goddess of Baby Sending) when she is slapping the babies backside telling it to be born. Others say it is because the baby does not want to leave the mother's womb so Songzi Guanyin will kick it out, leaving the bruise. While a small portion of people, wrongfully, believe it happens when the doctor is slapping the baby's backside to make it cry. Scientifically, it is also referred to as "蒙古斑" (Pinyin: Měng Gǔ Bān; Literally: Mongolian Spot)
In Khmer, it is known as "khnau" (ខ្នៅ) which translates to 'Mongolian spot' as well as other skin conditions such as vitiligo and leucoderma.
The mark is also common among Maya people of the Yucatan Peninsula where is referred to as "Wa" in Maya, which means "circle".
In Ecuador, the native Indians of Colta are insultingly referred to in Spanish by a number of terms which allude to the slate grey nevus.
In Spanish it is called "mancha mongólica" and "mancha de Baelz" (see Erwin Bälz).


Johann Friedrich Meckel

Johann Friedrich Meckel (17 October 1781 – 31 October 1833), often referred to as Johann Friedrich Meckel, the Younger, was a German anatomist born in Halle. He worked as a professor of anatomy, pathology and zoology at the University of Halle, Germany.
Life and research.
In 1802, he received his medical doctorate from the University of Halle, defending his doctoral thesis "De cordis conditionibus abnormibus" on 8 April 1802. At Halle he had as instructors, Kurt Sprengel (1766-1833) and Johann Christian Reil (1759-1813). After graduation, Meckel continued his education in Würzburg, Vienna and Paris. In Paris, he assisted zoologist Georges Cuvier (1769–1832) with systematic analysis of anatomical and zootomical specimens. In 1810 he finished translating Cuvier's five-volume "Leçons d’anatomie Comparée" from French into German.
In 1808, he became a full professor of normal and pathological anatomy, surgery and obstetrics at the University of Halle, replacing Justus Christian Loder (1753-1832). From 1826 to 1833, he was editor of the "Archiv für Anatomie und Physiologie". In 1829, he was elected a foreign member of the Royal Swedish Academy of Sciences.
Meckel adopted naturalist Jean-Baptiste Lamarck's (1744–1829) evolutionary beliefs. He was a pioneer in the science of teratology, in particular the study of birth defects and abnormalities that occur during embryonic development. He believed that abnormal development adhered to the same natural laws as did normal development. With French embryologist Étienne Serres (1786–1868), the "Meckel-Serres Law" is named, defined as a theory of parallelism between the stages of ontogeny and the stages of a unifying pattern in the organic world ("scala naturae").
Associated terms.
The following eponymous terms are named after him:
Family.
His grandfather was also named "Johann Friedrich Meckel". In order to avoid confusion, he is often referred to as Johann Friedrich Meckel, the Elder. The elder Meckel was also a professor of anatomy, and he too has anatomical structures named after him.
His father, Philipp Friedrich Theodor Meckel (1755–1803), was also an anatomist.
His brother, August Albrecht Meckel (1789–1829), practiced legal medicine and investigated avian anatomy but died prematurely from tuberculosis.
August's son – Johann Heinrich Meckel (1821–1856) – was the professor of pathologic anatomy at the University of Berlin that his great-grandfather had held at the Charité. After his death also from pulmonary disease, his position was filled by Rudolf Virchow.


Carl E. Misch

Carl E. Misch (November 17, 1947 – January 4, 2017) was an American prosthodontist recognized internationally for his clinical and academic contributions to the field of implant dentistry.
Biography.
Misch graduated magna cum laude in 1973 from the University of Detroit Dental School. He received his prosthodontic certificate, implantology certificate and Masters degree from the University of Pittsburgh School of Dental Medicine. The University of Yeditepe in Istanbul, Turkey and Carol Davila University of Medicine and Pharmacy in Bucharest, Romania each awarded Dr. Misch a Ph.D. (honoris causa). He holds several other post-graduate honors including twelve fellowships in dentistry, including the American College of Dentists, International College of Dentists, Royal Society of Medicine, American Association of Hospital Dentistry and the International Academy of Dentistry.
Career.
Misch was Clinical Professor in the Department of Periodontology and Oral Implantology, and Director of Oral Implantology (hon) in the School of Dentistry, Temple University Philadelphia, PA, USA. Misch served on the Board of Trustees at the University of Detroit Mercy where he was also an Adjunct Professor in the Department of Prosthodontics. He was Adjunct Professor at the University of Michigan, School of Dentistry in the Department of Periodontics/Geriatrics and Adjunct Professor at the School of Engineering in the Department of Biomechanics, at the University of Alabama at Birmingham. He was the Director of the Oral Implantology Residency Program at the University of Pittsburgh School of Dental Medicine from 1989 to 1996. Misch had maintained a private practice restricted to implant surgery (bone grafting and implant placement) and related prosthetics for more than 30 years. He previously practiced in Beverly Hills, Michigan.
In 1999, he authored the text, "Contemporary Implant Dentistry", and Misch has written three editions of Contemporary Implant Dentistry (Elsevier), which has become a very popular textbook that has been translated into 9 languages, including, Japanese, Spanish, Portuguese, Turkish, Italian and Korean. He has also written Dental Implant Prosthetics (Elsevier). He had published over 250 articles and has repeatedly lectured in every state in the United States as well as in 47 countries throughout the world.
In 1984, Misch founded the "Misch International Implant Institute" (MIII) in Beverly Hills, Michigan, which served as a one-year continuum for implant education. The MIII currently has locations in Florida and Nevada. Over the years, the MIII has been present in Brazil, Canada, France Italy, Japan, Korea, Monaco, Spain, and the United Kingdom. This program has (or is currently) the primary implant education forum for six dental school specialty residencies. Programs are offered in both the surgical and prosthetic aspects of care. Misch held 16 patents and was the co-inventor of the BioHorizons Maestro Implant System. He operated the Misch International Implant Institute, as a training center for dentists seeking to improve their skills in these techniques. To date, it has trained over 4,500 dentists.
Through a special affiliation arrangement with the institute, second year postgraduate periodontology students at Maurice H. Kornberg School of Dentistry at Temple University attend and participate on a tuition-free basis in six three-day advanced surgical oral implantology courses given at the Misch Institute. In tandem, Misch had been appointed as Clinical Professor and Director of Oral Implantology in the Department of Periodontology at the dental school. Jon Suzuki, past director of the periodontal program at Temple Dental School, and Thomas Rams, chairman of the same program, are both on surgical faculty at the institute.


Chronic recurrent multifocal osteomyelitis

Chronic recurrent multifocal osteomyelitis (CRMO) is a rare condition (1:1,000,000), in which the bones have lesions, inflammation, and pain. It is called "multifocal" because it can appear in different parts of the body, primarily bones, and "osteomyelitis" because it is very similar to that disease, although CRMO appears to be without any infection.
The definition of CRMO is evolving. Many doctors and articles described CRMO as an autoimmune disease that has symptoms similar to osteomyelitis, but without the infection. Some doctors thought CRMO was related to SAPHO syndrome. Research now classifies CRMO as an inherited autoinflammatory disease but have yet to isolate the exact gene or other causes responsible for it.
Classification.
Due to its inflammatory nature, its recurrent flares, and its lack of any known pathogen, CRMO has been reclassified as an autoinflammatory disease. This particular classification encompasses both hereditary types (familial Mediterranean fever, mevalonate kinase deficiency, TNF receptor associated periodic syndrome, cryopyrin-associated periodic syndrome, Blau syndrome, pyogenic sterile arthritis, pyoderma gangrenosum and acne syndrome, CRMO) and multifactorial disorders (Crohn's and Behçet's diseases). CRMO is no longer considered an autoimmune but rather an inherited, autoinflammatory disease.
Symptoms.
The most common symptom is extreme pain in a part of the body, it feels as though it’s right inside of you rather than a cut or scrape that you can feel on the surface of the skin. There also can be swelling and inflammation.
Diagnosis.
CRMO/CNO is a diagnosis of exclusion. This means that other diseases must be ruled out before the diagnosis can be made. Generally, many tests are required, such as blood tests, x-rays, bone scans, MRI and often a bone biopsy.
Treatment.
CRMO/CNO is generally treated by a specialist doctor (paediatric rheumatologist) who has experience with patients with CRMO/CNO.
Goals of treatment of CRMO/CNO include:
CRMO/CNO is different for each patient. Not every child responds to every treatment. Your doctor may need to try several medications before finding the one that works for your child. In severe cases, doctors may combine medications to treat the disease. Your doctor will work with you and your child to help find the best treatment. For some CRMO/CNO patients, the disease can be managed with non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs are the first line treatment. However, if NSAIDs are not effective, or if your child does not tolerate NSAIDs well, second line treatments are available.
First line treatments include Naproxen (Aleve), Celecoxib (Celebrex) Meloxicam (Mobic), Piroxicam (Feldene), Indomethacin (Indocin), Diclofenac (Voltaren). Second line treatments include corticosteroids (Prednisone/Prednisolone), Methotrexate (Otrexup, Rasuvo, Trexall), Sulfasalazine (Azulfidine), Pamidronate (Aredia), Zolendronic Acid (Zometa), Adalimumab (Humira), Etanercept (Enbrel), Infliximab (Remicade).
These medications are also used in children with other inflammatory and/or bone conditions. Side effects may occur while taking these medications.
Prognosis.
Prognosis will depend on your child's individual disease and response to treatment. It is best to discuss the prognosis with your child's pediatric rheumatologist.
Cause.
Some specialists believe they have discovered a link between CRMO with a rare allele of marker D18S60, resulting in a haplotype relative risk (HRR) of 18. Other experts found that "mutations in LPIN2 cause a syndromic form of chronic recurrent multifocal osteomyelitis known as Majeed syndrome, while mutations in pstpip2 cause a murine form of the disorder. The roles played by LPIN2 and the human homolog of pstpip2, PSTPIP2, in the cause of chronic recurrent multifocal osteomyelitis are uncertain. The professional theories seem to be moving in the direction of an inherited gene.
Epidemiology.
CRMO was once considered strictly a childhood disease, but adults have been diagnosed with it. The affected tends to range from 4 to 14 years old, with 10 as the median age. As stated above, CRMO occurs 1:1,000,000 and primarily in girls with a 5:1 ratio. That means out of six million, there will probably be 5 girls and 1 boy with the condition.
Majeed syndrome.
Majeed syndrome is an autoinflammatory disorder consisting of CRMO, congenital dyserythropoietic anemia, and neutrophilic dermatosis. To date, two unrelated families with Majeed syndrome have been reported. Mutations in LPIN2 have been found in both families. Here we report a third consanguineous family with Majeed syndrome with a novel mutation. The patient, a 3-year-old Arabic girl, had hepatosplenomegaly and anemia as a neonate. At age 15 months, she developed recurrent episodes of fever and multifocal osteomyelitis. In addition, bone marrow aspiration demonstrated significant dyserythropoiesis (defective red cell formation), suggesting Majeed syndrome. Coding sequences and splice sites of LPIN2 were sequenced in the patient and her mother. A homozygous single-basepair change was detected in the donor splice site of exon 17 (c.2327+1G>C) in the patient; her mother was heterozygous at this site. These data confirm the role of LPIN2 mutations in the cause of Majeed syndrome.
Congenital dyserythropoietic anemia and chronic recurrent multifocal osteomyelitis, uncommon childhood diseases of unknown cause, occurred in three children (two brothers and a female cousin). Their parents are consanguineous, and the clinical course of their illness was similar. The two brothers also had Sweet syndrome. The association of Sweet syndrome with chronic recurrent multifocal osteomyelitis and congenital dyserythropoietic anemia in this family suggests that these rare conditions may be interrelated.


Paresh Doshi

Paresh Kishorchandra Doshi M.S., M.Ch. (born 1963) is a neurosurgeon who practices stereotactic and functional neurological surgery in India.
He is working as the Director of Neurosurgery, at the Jaslok hospital and research centre, Mumbai, India


Walery Jaworski

Walery Jaworski (born March 20, 1849 in Florynka – died July 17, 1924 in Kraków) was one of the pioneers of gastroenterology in Poland.
In 1899 he described bacteria living in the human stomach that he named "Vibrio rugula". He speculated that they were responsible for stomach ulcers, gastric cancer and achylia. It was one of the first observations of Helicobacter pylori. He published those findings in 1899 in a book titled "Podręcznik chorób żołądka" ("Handbook of Gastric Diseases") but it was available only in Polish and went unnoticed.
His findings were independently confirmed by Robin Warren and Barry Marshall, who received the Nobel Prize in 2005.


Rabindra Narain Singh

Rabindra Narain Singh is an Indian orthopedic surgeon and the former president (2006–07) of Bihar Orthopedic Association. He is an honorary consultant at "Anup Memorial Orthopaedic Centre and Research Institute", a Patna-based orthopedic healthcare centre and the director of "Anup Institute of Orthopaedics and Rehabilitation". He is a Fellow of the Royal College of Surgeons of Edinburgh and the Indian Medical Association Academy of Medical Specialists. He holds the chair of the Institute Ethics Committee of the All India Institute of Medical Sciences, Patna, a member of the Ad-hoc Committee of the Bihar chapter of the Indian Red Cross Society and a life member of the "Indian Foot and Ankle Society". The Government of India awarded him the fourth highest civilian honour of the Padma Shri, in 2010, for his contributions to medical science.


Cephalic brain-like heterotopia


Naval Medical Research Unit Five

Naval Medical Research Unit Five (NAMRU-5) was a research laboratory of the US Navy which was founded as a field facility of Naval Medical Research Unit 3 in Addis Ababa Ethiopia with a collecting station in Gambella on December 30, 1965 under an agreement between the US and Ethiopian governments. In 1974 NAMRU-5 was established as its own command and was housed in the Ethiopian Health and Nutrition Research Institute(former Imperial Central Laboratory Research Institute). The mission of NAMRU-5 was to conduct research and development on infectious diseases of military importance in sub-Sahara Africa. Gambella became the focus of a major malaria control effort and studies on malaria immunology. Applied research focused on the general areas of insect repellents, insecticide resistance, insect attractants and louse control. Members of the NAMRU-5 staff were also among the last Americans to ever see smallpox before its eradication. NAMRU-5 built collaborative research efforts with the U.S. Centers for Disease Control and Prevention; with local medical facilities, including the Haile Selassie University Medical School and various hospitals in Addis Ababa; and with the London School of Tropical Medicine, the University of Washington, Case Western Reserve University Department of Medicine and the University of Maryland School of Medicine. NAMRU-5 was disestablished in April 1977 following the communist takeover of the government of Ethiopia which ordered all members out of the country in 4 days.
Fields of study included:


Carl Friedrich Flemming

Carl Friedrich Flemming (27 December 1799 – 27 January 1880) was a German psychiatrist born in Jüterbog. He was the father of cellular biologist Walther Flemming (1843-1905).
After receiving his medical doctorate from Berlin, he worked as an assistant at the "Irrenheilanstalt Sonnenschein" (Sonnenschein mental asylum) near Pirna. From 1830 to 1854 he was director of the new psychiatric hospital at Sachsenberg, and afterwards maintained a private practice in Schwerin.
In 1844 he introduced the term "dysthymia mutabilis" to describe a disorder that is an alternation of "dysthymia atra" (black depression) and "dysthymia candida" (low-level mania). He was part of the somatic school who held that insanity is a symptom of biological diseases located outside the brain, particularly diseases of the abdominal and thoracic viscera, akin to the delirium caused by many acute biological illnesses.
Flemming died in Wiesbaden.


Themison of Laodicea

Themison of Laodicea (, "gen." Θεμίσωνος; fl. 1st century BC) was the founder of the Methodic school of medicine, and one of the most eminent physicians of his time.
Biography.
Themison was a native of Laodicea in Syria, and a pupil of Asclepiades of Bithynia. Nothing more is known about the events of his life except that he seems to have travelled a great deal; as he mentions Crete and Milan, apparently as an eye-witness. Neither is it certain if he ever visited Rome, though it is perhaps more probable that he did so. He differed from his teacher on several points in his old age, and became the founder of a new sect called the Methodic school ("Methodici"), which long exercised an extensive influence on medical science. He wrote several medical works, but in what language is not mentioned; of these only the titles and a few fragments remain, preserved principally by Caelius Aurelianus, for example: "Libri Periodici"; "Epistolae" in at least nine books; "Celeres Passiones" in at least two books; "Tardae Passiones" in at least two books; "Liber Salutaria"; "De Plantagine".
He was perhaps the first physician who made use of leeches, and he is said to have been attacked with hydrophobia, and to have recovered. Eudemus and Proculus are said to have been followers () of Themison, which may only mean that they belonged to the Methodic school.
Themison was criticized by Soranus for his cruel handling of mental patients. Among his prescriptions were darkness, restraint by chains, and deprivation of food and drink. Juvenal satirized him and suggested that he killed more patients than he cured, but whether he means this Themison or some contemporary is unknown.


Neonatal tetanus

Neonatal tetanus is a form of generalised tetanus that occurs in newborns. Infants who have not acquired passive immunity from an immunized mother are at risk. It usually occurs through infection of the unhealed umbilical stump, particularly when the stump is cut with a non-sterile instrument. Neonatal tetanus mostly occurs in developing countries, particularly those with the least developed health infrastructure. It is rare in developed countries.
Signs and symptoms.
In neonatal tetanus, symptoms usually appear from 4 to 14 days after birth, averaging about 7 days. The fatality rate for infants has been estimated as 70% to 100%; death usually occurs by the age of 2 weeks. On the basis of clinical findings, four different forms of tetanus have been described. The time from exposure to symptoms may be up to several months.
The neonate is unable to suck and cry, is rigid, and develops spasms.
Prevention.
The spores which cause tetanus are present everywhere, so the only prevention is immunization. Three properly spaced doses of tetanus toxoid vaccine are recommended for women of childbearing age, either before or during pregnancy; this will protect their future babies from neonatal tetanus after delivery.
Public health campaigns.
In 1989, the World Health Congress called for the elimination of neonatal tetanus. UNICEF took the lead, assisted by other United Nations agencies, individual governments, and non-profit organisations. By 2000, the disease was declared as eliminated from 104 of 161 developing countries. "Elimination" is defined as less than 1 case per 1,000 live births in every district of the country. Since tetanus can also strike postpartum mothers, the campaign has been expanded to target both maternal and neonatal tetanus.
In many affected countries, there was a lack of awareness of maternal and neonatal tetanus and how to prevent it. Education and immunisation campaigns have been launched in the remaining countries at risk and are targeted particularly at pregnant women. Education focuses on hygienic birth practices and infant cord care as well as the need for immunisation.
In Egypt, the number of cases of neonatal tetanus dropped from 4,000 to fewer than 500 annually as the result of an immunisation campaign. In Morocco, neonatal tetanus accounted for 20% of neonatal deaths in 1987 but only 2% in 1992. In 1998 in Uganda, 3,433 tetanus cases were recorded in newborn babies; of these, 2,403 died. After a major public health effort, Uganda in 2011 was certified as having eliminated tetanus. In 2011, Pampers joined with UNICEF to target maternal and neonatal tetanus in Yemen. In 2010, Kiwanis International pledged to raise $110 million to eliminate maternal and neonatal tetanus throughout the world in partnership with UNICEF.
On 15May 2015, the World Health Organization (WHO) declared India free from maternal and neonatal tetanus. India has reduced its infant mortality rate (IMR) from 380 per 1000 live births in 1990, to 40 in 2015, and its maternal mortality rate (MMR) from 540 per 100,000 to 167 in the same years. The national health programme was started in 1983 by the Government of India, when all pregnant women were given two doses of tetanus vaccine. The number of deaths from tetanus dropped from 79,000 in 1990, to less than 500 in 2013 and 2014.
Epidemiology.
In 2000, neonatal tetanus was responsible for about 14% (215,000) of all neonatal deaths. In 2008, 59,000 newborns worldwide died as a result of neonatal tetanus. In 2005, 57 countries were identified as still at risk, with 27 countries accounting for 90% of cases. As of December 2013 the number of countries at risk was reduced to 25.


Hampton hump

Hampton's hump, also called Hampton hump, is a radiologic sign which consists of a shallow wedge-shaped opacity in the periphery of the lung with its base against the pleural surface. It is named after Aubrey Otis Hampton, who first described it in 1940. Hampton's hump along with Westermark sign may aid in the diagnosis of pulmonary embolism, although they are rare and their sensitivities and interoperator reliabilities are low. If the sign is present in an image, there is a high chance that the person has a pulmonary embolism, but when the sign is absent a pulmonary embolism is not ruled out.


Fernand Lamaze

Fernand Lamaze (; 1891–1957) was a French obstetrician, most famous as the popularizer of psychoprophylaxis, a method of childbirth preparation and pain management that bears his name (the Lamaze technique).
Career.
Lamaze visited the Soviet Union in 1951. There, he observed a birth using psychoprophylaxis, which had been developed primarily by Soviet psychotherapist I.Z. Velvovskii of Kharkov, Ukraine.
Based on Ivan Pavlov's theory of conditioned response, psychoprophylaxis strove to eliminate the pain of childbirth through education about the physiological process of labor and delivery, through the trained relaxation response to uterine contractions, and through patterned breathing intended to both increase oxygenation and interfere with the transmission of pain signals from the uterus to the cerebral cortex. Lamaze was so impressed by what he witnessed that after he returned to France, he devoted the rest of his life to promoting psychoprophylaxis.
Criticism.
Lamaze has been criticized for being over-disciplinary and anti-feminist; "[t]he disciplinary nature of Lamaze’s approach to childbirth is evident from Sheila Kitzinger’s description of the methods he deployed while working in a Paris clinic during the 1950s. According to Sheila Kitzinger, Lamaze consistently ranked the women’s performance in childbirth from 'excellent' to 'complete failure' on the basis of their 'restlessness and screams.' Those who 'failed' were, he thought, 'themselves responsible because they harbored doubts or had not practiced sufficiently,' and, rather predictably, 'intellectual' women who 'asked too many questions' were considered by Lamaze to be the most 'certain to fail.'"