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  • 11
    Electronic Resource
    Electronic Resource
    Compensatory neoplasia: Chronic erythrocytosis and neuroblastic tumors (1984)
    Springer
    Theoretical medicine and bioethics 5 (1984), S. 279-291 
    Details
    ISSN: 1573-1200
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Philosophy
    Notes: Abstract There are a large number of exogenous biological and chemical substances with known neoplastic or carcinogenic potential. However, it has also been postulated that external stimuli can influence the body's internal milieu, and thereby induce compensatory excessive growth of cells in the form of hyperplasia or neoplasia. In a recent study, we observed a strong association between chronic hypoxic states and the occurrence of peripheral neuroblastic tumors, a relatively uncommon group of neural neoplasms. In this report we review those findings and formulate an hypothesis to explain why conditions which lead to chronic erythrocytosis may also cause compensatory neoplasia of neural tissues.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00489476
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  • 12
    Electronic Resource
    Electronic Resource
    A new paradigm for hypothesis testing in medicine, with examination of the Neyman Pearson condition (1986)
    Springer
    Theoretical medicine and bioethics 7 (1986), S. 269-282 
    Details
    ISSN: 1573-1200
    Keywords: Computer simulation ; Hypothesis test ; Neyman Pearson lemma ; Token swap test
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Philosophy
    Notes: Abstract In the past, hypothesis testing in medicine has employed the paradigm of the repeatable experiment. In statistical hypothesis testing, an unbiased sample is drawn from a larger source population, and a calculated statistic is compared to a preassigned critical region, on the assumption that the comparison could be repeated an indefinite number of times. However, repeated experiments often cannot be performed on human beings, due to ethical or economic constraints. We describe a new paradigm for hypothesis testing which uses only rearrangements of data present within the observed data set. The token swap test, based on this new paradigm, is applied to three data sets from cardiovascular pathology, and computational experiments suggest that the token swap test satisfies the Neyman Pearson condition.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00539848
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  • 13
    Electronic Resource
    Electronic Resource
    Determining cause of death in 45,564 autopsy reports (1988)
    Springer
    Theoretical medicine and bioethics 9 (1988), S. 179-186 
    Details
    ISSN: 1573-1200
    Keywords: Autopsy diagnosis ; Cause of death ; Computer registers ; Diagnosis ; Medical subject headings ; Personal registers ; Validity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Philosophy
    Notes: Abstract It has been demonstrated that death certificates do not accurately record the actual cause of death in up to one-fourth of cases, as determined from subsequent autopsy findings. The purpose of this study was to explore the use of natural language autopsy data bases as an automated quality assurance mechanism. We translated the account of the major process leading to death, or the primary diagnosis, from all 45,564 narrative autopsy reports obtained at The Johns Hopkins Hospital between May 28, 1889, and June 30, 1987, into the hierarchical system of Medical Subject Heading (MeSH) titles. We obtained a total of 125,772 MeSH title translations, 1,563 of them distinct (average 2.8 per case), ranging in frequency from 6,029 occurrences of LUNG to 1 occurrence apiece of 357 MeSH titles. The natural-language-to-MeSH translations showed expected trends over the past century: fewer infectious diseases; more cardiovascular and neoplastic disease among adults; and more respiratory diseases and congenital malformations in the pediatric age group. The greater availability of autopsy documents in electronic form should increase the value of this resource for quality assurance.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00489411
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  • 14
    Electronic Resource
    Electronic Resource
    Three paradoxes of medical diagnosis (1981)
    Springer
    Theoretical medicine and bioethics 2 (1981), S. 197-215 
    Details
    ISSN: 1573-1200
    Keywords: Medical diagnosis ; Paradox ; Certainty levels ; Symbolic logic ; Consistency ; Logic of medicine ; Automated diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Philosophy
    Notes: Abstract Sadegh-zadeh [23] has proposed a theory of the relativity of medical diagnosis in terms of the time at which a diagnosis is accepted, the patient to whom the diagnosis applies, the physician who renders the diagnosis, the medical knowledge used, the diagnostic method applied, and the set of patient observations. Use of classical formal logic as the ‘diagnostic method’ may result in three paradoxes: the paradoxes of consistency, completeness, and justifiable ignorance. These paradoxes may be resolved by the addition of two non-classical operators, the ‘certainty’ and ‘effort’ operators, akin to the non-classical operators of modal logic.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00884423
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  • 15
    Electronic Resource
    Electronic Resource
    A hintikka possible worlds model for certainty levels in medical decision making (1981)
    Springer
    Synthese 〈Dordrecht〉 48 (1981), S. 87-119 
    Details
    ISSN: 1573-0964
    Source: Springer Online Journal Archives 1860-2000
    Topics: Natural Sciences in General , Philosophy
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01064630
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  • 16
    Electronic Resource
    Electronic Resource
    Role of the left interventricular sulcus in formation of the interventricular septum and crista supraventricularis in normal human cardiogenesisSupported by an Institutional Research Grant from The Johns Hopkins University School of Medicine and Grant 1 R01 HL 22963 from The National Institutes of Health, Public Health Service, Department of Health, Education and Welfare. (1979)
    New York, NY [u.a.] : Wiley-Blackwell
    The @Anatomical Record 194 (1979), S. 417-428 
    Details
    ISSN: 0003-276X
    Keywords: Life and Medical Sciences ; Cell & Developmental Biology
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Medicine
    Notes: Serial sections of normal human embryos were studied and three-dimensional images reconstructed to determine the early development of the interventricular septum. The position of the interventricular septum is determined in stage 9 of normal development by the formation of the left interventricular sulcus. As a result of unknown properties of the cells of the myocardial layer, the left interventricular sulcus persists while the right disappears, producing the initial lateral asymmetry of the primary heart tube. By stage 14, the left interventricular sulcus forms a spiral which is continuous with the developing interventricular septum. The dorsal limb of the spiral passes to the right between the atrioventricular canal and the origin of the outflow tract, and is lost in the wall of the trabeculated right ventricle. It appears that this dorsal limb of the spiral is the precursor of part of the cirsta supraventricularis. The midportion of the sulcus, the bulboventricular groove, becomes the socalled fibrous continuity between the aortic and mitral valves. The ventral limb of the spiral passes caudally in the anterior interventricular groove and then dorsally and cranially toward the dorsal cushion of the atrioventricular canal. The ventral limb of the spiral is continuous with the crest of the muscular interventricular septum, which develops by apposition of tissue from the expanding right and left ventricles. From stage 14 to stage 19, the muscular interventricular septum, the atrioventricular endocardial cushions, and the ventricular end of the spiral ridges of the outflow tract appose and fuse. Subsequent formation of the membranous interventricular septum completes the physical separation of the right and left ventricles.
    Additional Material: 6 Ill.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/ar.1091940308
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  • 17
    Electronic Resource
    Electronic Resource
    Development of the atrioventricular valve region in the human embryo (1986)
    New York, NY [u.a.] : Wiley-Blackwell
    The @Anatomical Record 215 (1986), S. 167-181 
    Details
    ISSN: 0003-276X
    Keywords: Life and Medical Sciences ; Cell & Developmental Biology
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Medicine
    Notes: Severe cardiac malformations may involve the atrioventricular valve region, but the sequence of embryonic development of this important area has been little studied. In particular, the basis of atrioventricular muscular discontinuity, except at the conduction system, has remained unexplained. To examine this question, serial histologic sections of human embryos from the Carnegie Embryo-logical Collection and from the Hopkins Pathology Collection were studied and six embryos were reconstructed. The atrioventricular sulcus can be identified in Carnegie stage 10 as an indentation or crease on the right side separating the heart tube from the umbilical vein. By stage 12 the sulcus has deepened and rotated anteriorly as the atria appear and the heart tube elongates rapidly within the confining pericardial space. Selective accumulation of cardiac jelly on the endocardial aspect of the constriction of the heart tube produced by the atrioventricular sulcus is pronounced by stage 14. By stage 16 the separation of the atrioventricular orifice into right and left components is well advanced, and by stage 18 the septation of the atria and ventricles is largely complete. The muscular connection between the atria and the ventricles becomes interrupted around most of the artioventricular sulcus, except for the His bundle, during the latter part of the embryonic period. The topography of the original sulcus assumes a catenoidal or saddle-shaped configuration, i.e., convex in one plane and concave in the perpendicular plane. The tension and pressure relationships in such a structure would favor cardiac jelly accumulation and the eventual disintegration of lines of myocyte connections passing across the groove. The preservation of the His bundle connection is explained by the failure of the sulcus to completely encircle the heart.
    Additional Material: 16 Ill.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/ar.1092150210
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  • 18
    Electronic Resource
    Electronic Resource
    A proposed mechanism for the early development of the human tracheobronchial tree (1981)
    New York, NY [u.a.] : Wiley-Blackwell
    The @Anatomical Record 201 (1981), S. 635-640 
    Details
    ISSN: 0003-276X
    Keywords: Life and Medical Sciences ; Cell & Developmental Biology
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Medicine
    Notes: The development of the lung in 25 human embryos and early fetuses up to 140 mm crown-rump length was studied by examination of serial histologic sections, morphometry, and selected reconstructions. The proportion of pulmonary tissue consisting of tracheobronchial tree increases during this period. Bronchial cross-sectional diameter, length of the most distal bronchial branches, and thickness of the distal mesenchyme decline during development. The results are consistent with the concept that the dichotomous branching of the growing tracheobronchial tree occurs because of resistance to forward growth of the bronchial branch by compressed mesenchyme, pleura, or adjacent structures. Division and further growth of the bronchus takes place in areas of lower resistance. This process produces a “filling in” of space available for lung development and brings the epithelial and mesenchymal elements into their definitive relationships.
    Additional Material: 4 Ill.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/ar.1092010407
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  • 19
    Electronic Resource
    Electronic Resource
    Rotation of the junction of the outflow tract and great arteries in the embryonic human heart (1986)
    New York, NY [u.a.] : Wiley-Blackwell
    The @Anatomical Record 216 (1986), S. 544-549 
    Details
    ISSN: 0003-276X
    Keywords: Life and Medical Sciences ; Cell & Developmental Biology
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Medicine
    Notes: The factors which give rise to the normal relationship between the great arteries and their respective ventricles are unknown. The developmental anatomy of this region was studied by using frontal, sagittal, or transverse serial histologic sections of 17 normal human embryos of Carnegie stages 15-19 from the Carnegie Embryological Collection. Distances and angles between major anatomic landmarks were determined by using computer reconstructions of the serially sectioned embryos, three-dimensional analytic geometry, and Euclidean distance formulas. The findings show that between stages 15 and 19 there is a marked rotation of the axis of the semilunar valves: frontal 121° counterclockwise, sagittal 196° counterclockwise, and transverse 240° clockwise. Simultaneously the great arteries lengthen at a faster rate than the rest of the heart; and there is also an increase in the caliber and wall thickness of the great arteries. These results suggest that the changing rate of growth between the great arteries and the heart is necessary to align the great arteries, the semilunar valves, and the muscular outflow tract septum appropriately with respect to the interventricular septum. Reductions in the rate of growth of the great arteries relative to the heart could, by causing changes in the rotation of great arteries and outflow tract septum, have a role in the pathogenesis of cardiovascular malformations such as tetralogy of Fallot and transposition of the great arteries.
    Additional Material: 3 Ill.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/ar.1092160412
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  • 20
    Electronic Resource
    Electronic Resource
    Connective tissue arrangement in respiratory airways (1980)
    New York, NY [u.a.] : Wiley-Blackwell
    The @Anatomical Record 198 (1980), S. 245-254 
    Details
    ISSN: 0003-276X
    Keywords: Life and Medical Sciences ; Cell & Developmental Biology
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Medicine
    Notes: Connective tissue provides dynamic stability to the architecture and mechanical function of the lungs. This study examines the parenchymal connective tissue components of the alveolar ducts, their associated respiratory bronchioles and respective alveoli. Thick sections 100μ and 200μ, and serial sections at 8μ of lungs of different ages were examined histologically after fixation in distention. The varying proportions and spatial architecture of the collagen and elastic fibers and the packing and spatial interrelationships of alveoli were studied using graphic serial reconstruction. Alveolar mouths typically have a polygonal configuration as they arise from the airways. Denser connective tissue passes through the polygonal array and forms a helix encircling the airway. Polygonal packing of alveolar mouths provides a mechanically stable ductular structure with conservation of materials. A helical modification of the polygonal arrangement permits reversible changes in linear and circumferential airway dimensions.
    Additional Material: 5 Ill.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1002/ar.1091980211
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