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Bacterial growth and division; Biochemistry Restriction are proteins that are produced by as a defense mechanism against that infect the bac- teria (bacterial phages) cheap urispas 200 mg visa. Most bacteria have restriction modification systems that consist of methylases and restriction enzymes generic 200 mg urispas otc. In such systems a bacteria’s own is modified by methylation (the addition of a methyl group, CH3) at a specific location determined by a specific pattern of nucleotide residue and protected from degradation by specialized enzymes termed endonucleases. The names of restriction enzymes are created from the first letter of the bacterial genus followed by the first two let- ters of the species plus a Roman numeral if more than one restriction enzyme has been identified in a particular species. Thus, the fifth restriction enzyme from is called EcoRV (pronounced e, ko, r five). Besides , restriction enzymes are used in techniques, linking the genome directly to a conventional genetic marker. Any DNA molecule, from viruses to humans, contains restriction-enzyme target sites purely by chance and, there- fore, may be cut into defined fragments of size suitable for cloning. Restriction sites are not relevant to the function of the organism, nor would they be cut because most organ- isms do not have restriction enzymes. Some enzymes cut DNA at the same position of 1000 base pairs beyond the recognition site. Type II recognizes short Cell cycle (prokaryotic), genetic regulation of; DNA DNA of four to eight nucleotides. Type II restriction enzymes (Deoxyribonucleic acid); Gene amplification; Gene; Genetic are widely used in. Type II restriction code; Genetic identification of microorganisms; Genetic map- enzymes have two properties useful in recombinant DNA ping; Genetic regulation of eukaryotic cells; Molecular biol- technology. First, they cut DNA into fragments of a size suit- ogy and molecular genetics able for cloning. Second, many restriction enzymes make staggered cuts generating single-stranded ends conducive to the formation of recombinant DNA. Hamilton Smith identi- fied the first type II restriction enzyme, HindII, in 1970 at Johns Hopkins University. For example, restriction enzyme EcoRI (from Transposable elements are relatively long sequences in the bacterium ) recognizes the following six- prokaryotic and eukaryotic genomes that act as mobile genetic nucleotide-pair sequence in the DNA of any organism: elements. These elements, which represent a large part of the 5’–GAATTC–3’, 3’–CTTAAG–5’. This type of segment is genomes of many species transpose by a mechanism that called a DNA palindrome, which means that both strands have involves DNA synthesis followed by random integration at a the same nucleotide sequence but in antiparallel orientation. EcoRI cuts in the six-base-pair DNA between the G and the A All transposable elements encode for transposase, the nucleotides. This staggered cut leaves a pair of identical single special enzyme activity that helps in the insertion of Diagram showing specific base pairing found in DNA and RNA. WORLD OF MICROBIOLOGY AND IMMUNOLOGY RUSKA, ERNST (1906-1988) 496 through came when his fellow physician, Jakob Kolletschka (1803–1847), died of blood poisoning after cutting his finger while performing an autopsy. Semmelweis noticed that the Seroconversion is a term that refers to the development in the pathological features of the autopsy on Kolletschka’s body blood of antibodies to an infectious organism or agent. Typically, seroconversion is associated with infections caused Semmelweis then only suspected, and did not prove, that the by , , and protozoans. But seroconversion also fever was a septicemia, an intrusion of from occurs after the deliberate inoculation with an in the a local infection into the bloodstream, but he instantly took process of. In May 1847, he ordered all personnel under his ment of detectable levels of antibodies can occur quickly, in authority to wash their hands between patients. This was a the case of an active infection, or can be prolonged, in the case novel, radical, and unpopular rule, but in just a month the of a latent infection. Seroconversion typically heralds the maternal death rate at the Vienna General Hospital dropped development of the symptoms of the particular infection. The phenomenon of seroconversion can be important in Even though Semmelweis had solid results and statistics diagnosing infections that are caused by latent viruses. When these viruses first infect people, the viral nucleic many powerful enemies, and in March 1849, he was demoted acid can become incorporated into the genome of the host. Rochus Hospital in a result, there will not be an immune response mounted Pest from 1851 to 1857, but never achieved his former profes- against the virus.

Eight-and-a-half syndrome: One-and-a-half syn- drome plus cranial nerve VII palsy order urispas 200 mg visa. Journal of Neuro-ophthalmology 1998; 18: 114-116 Wolin MJ generic urispas 200 mg without prescription, Trent RG, Lavin PJM, Cornblath WT. Oculopalatal myoclonus after the one-and-a-half syndrome with facial nerve palsy. Ophthalmology 1996; 103: 177-180 Cross References Facial paresis; Myoclonus; One-and-a-half syndrome; Palatal myoclonus Emotionalism, Emotional Lability Emotionalism or emotional lability, or emotional incontinence, implies both frequent and unpredictable changes in emotional expres- sion, for example tearfulness followed shortly by elation, and an inappropriate expression of emotion, for example uncontrollable (“uninhibited” or disinhibited) laughter or crying. A distinction may be drawn between the occurrence of these phe- nomena spontaneously or without motivation, or in situations which although funny or sad are not particularly so. Also, a distinction may be made between such phenomena when there is congruence of mood - 109 - E Emposthotonos and affect, sometimes labeled with terms, such as moria or witzelsucht (e. The neurobehavioral state of emotional lability reflects frontal lobe (especially orbitofrontal) lesions, often vascular in origin, and may coexist with disinhibited behavior. Pathological laughter and crying may occur as one component of pseudobulbar palsy (“pseudobulbar affect”). Oxford: OUP, 2003: 447-478 Cross References Delirium; Disinhibition; Frontal lobe syndromes; Moria; Pathological crying, Pathological laughter; Pseudobulbar palsy; Witzelsucht Emposthotonos Emposthotonos is an abnormal posture consisting of flexion of the head on the trunk and the trunk on the knees, sometimes with flexion of the limbs (cf. Such attacks of “bowing” may be seen in infantile epilepsy syndromes, such as West’s syndrome, sometimes called salaam seizures or jack-knife spasms. Cross References Opisthotonos; Seizures; Spasm Encephalopathy Encephalopathy is a general term referring to any acute or chronic diffuse disturbance of brain function. Characteristically it is used to describe an altered level of consciousness, which may range from drowsiness to a failure of selective attention, to hypervigilance; with or without: disordered perception, memory (i. As with terms, such as coma and stupor, it is probably better to give a description of the patients clinical state rather than use a term that is open to variable interpretation. Although the term is sometimes reserved for metabolic causes of diffuse brain dysfunction, this usage is not universal. Conditions which may be described as an encephalopathy include: Metabolic disorders: hypoxia/ischemia, hypoglycemia; organ fail- ure, electrolyte disturbances, hypertension - 110 - Environmental Tilt E Drug/toxin ingestion Brain inflammation/infection (e. Cross References Asterixis; Coma; Delirium; Myoclonus; Stupor; Tremor En Garde Position - see FENCER’S POSTURE; FENCING POSTURE Enophthalmos Enophthalmos is an inward displacement of the eyeball (sinking or withdrawal) into the eye socket (cf. It is classically described as one of the cardinal features of Horner’s syndrome (along with miosis, ptosis, and anhidrosis) but is seldom actually measured. Enophthalmos may also occur in dehydration (probably the most common cause), orbital trauma (e. Cross References Anhidrosis; Exophthalmos; Hemifacial atrophy; Horner’s syndrome; Miosis; Ptosis Entomopia Entomopia (literally “insect eye”) is the name given to a grid-like pat- tern of multiple copies of the same visual image; hence, this is a type of polyopia. This phenomenon has been reported in migraine; its pathogenesis is uncertain. Neurology 1993; 43: 2145-2146 Cross References Polyopia Environmental Dependency Syndrome - see IMITATION BEHAVIOR; UTILIZATION BEHAVIOR Environmental Tilt Environmental tilt, also known as tortopia, is the sensation that visual space is tilted on its side or even upside down (“floor-on-ceiling” phe- nomenon, “upside-down” reversal of vision, verkehrtsehen). The temptation to dismiss such bizarre symp- toms as functional should be resisted, since environmental tilt is pre- sumed to reflect damage to connections between cerebellar and central vestibular-otolith pathways. It has been reported in the following situations: Lateral medullary syndrome of Wallenberg Transient ischemic attacks in basilar artery territory - 111 - E Epiphora Demyelinating disease Head injury Encephalitis Following third ventriculostomy for hydrocephalus Cross References Lateral medullary syndrome; Vertigo; Vestibulo-ocular reflexes Epiphora Epiphora is overflow of tears down the cheek. This may be due to a blocked nasolacrimal duct, or irritation to the cornea causing increased lacrimation, but it may also be neurological in origin, e. Lacrimation is also a feature of trigeminal autonomic cephalalgias, such as cluster headache. Cross References Bell’s palsy; Crocodile tears Epley Maneuver - see HALLPIKE MANEUVER, HALLPIKE TEST; VERTIGO Erythropsia This name has been given to a temporary distortion of color vision in which objects take on an abnormal reddish hue. There are various causes, including drug use, visual diseases, and pseudophakia. Cross References Illusion; “Monochromatopsia”; Phantom chromatopsia Esophoria Esophoria is a variety of heterophoria in which there is a tendency for the visual axes to deviate inward (latent convergent strabismus).

By 1939 purchase urispas 200 mg with amex, his first career in Barcelona begin the last of his careers buy generic urispas 200 mg on line, once again in had ended. While still maintaining a busy clinical he called “the sad privilege” of his responsibility practice, he wrote a biography of G. Girdle- for the first urban population in history to be mas- stone, whom he admired above all, prepared his sively attacked from the air. His second career, as own memoirs, read history and lectured his way an emigré in an Oxford laboratory unraveling around the world. Gradually, as the political some of the complexities of the renal circulation, climate in his country changed, the people of Cat- was brief but characteristically fruitful and is now alonia saw him for the patriot he had always been, embalmed in the textbooks of physiology. It was and before he died the reconciliation between the in his third incarnation as Oxford’s professor that great surgeon and the country that he had fled his remarkable experience was built upon, broad- nearly 40 years before was completed by his ened and generously shared with anyone who acceptance of the highest honor the King of Spain cared to join him. And more significant yet of the everything at once, bombarding himself with extraordinary regard in which he was held, the questions, which sprang to his mind even from the citizens of Barcelona crowded the great church of most mundane of clinical problems. He was the Santa Maria del Mar to hear his funeral mass and very master of the art of digression, and yet to listen to the music of Pablo Casals, his old capable of directing his energy to laboratory friend and fellow exile. The discipline he pedics, the breadth of Joseph Trueta’s interests offered, that we should combine most intimately and influence, his sense of the drama of life and our therapeutic and research roles, was not a new even perhaps his splendid misuse of the spoken one, but it has more theoretical adherents than it English language all conspired to keep him a little has practitioners. He taught it by precept and apart from “The Establishment,” which, with thereby caught the imagination of many of those another side of his personality, he so earnestly who came from all over the world to work with wished to join. He had little formal order in his life, was When Joseph and Amelia Trueta brought their always tremendously busy but somehow had time young family to England and were befriended by for everyone. Girdlestone, there was started a process that Trueta’s long investigation, with generations of now links in a mutual experience some hundreds collaborators, into the vascular contribution to of men and women in many countries of the osteogenesis, the vascular anatomy of bone, world. They remember the debonair, provocative the orderly and the disorderly function of the and profoundly civilized man who enlarged our epiphysis, cartilage growth, repair and decay, concept of the orthopedic surgeon to include the 336 Who’s Who in Orthopedics orthopedic scientist, and who by his example per- Orthopedic Centre at Headington, which was to sonified both. He generated Spanish Civil War, which was so relevant to what a sense of authority, which was totally divorced was about to break on Britain. As conclusion the man with the piercing blue eyes an orthopedic thinker, he will probably be judged who had interrupted came and grasped his hand by posterity as one of the most outstanding in his with both his own and urged him to visit him in generation, yet he was completely open to ideas Oxford. His scientific ethos was the primal position of and gave everything he could to assist him, and the vasculature in health and disease. Likewise it was came to Oxford under the influence of his own the essence of his novel concepts of the cause inspiration. When the He believed that the capillaries held the key to the violence of the Spanish Civil War was ultimately understanding of the mysteries of development replaced by peacetime Oxford, there were always and decay of the human skeleton. His views, exciting plans, unexpected setbacks, overcrowded always unusual, were presented with passion in calendars and last-minute departures. Nothing his own special brand of English, spoken with an ran smoothly for very long, but the ending was arresting Catalan accent. Then it natural refinement will remain bright in the minds was back to the data and the experiment for of all who knew him. He was a erable efforts, because in 1947 he had to use the benign father to many of us. Some of us may have animal house at the Royal Veterinary College in regrets that we did not repay more, but we will all London for his studies on long bone vasculariza- be grateful for having known a man so great. Later he established his own facilities at the Nuffield Orthopedic Centre, surely the first in a British orthopedic hospital. For 20 years he was the acknowledged leader of one aspect of the emerging science of orthopedics—the investiga- tion of the disordered biology of bone. He was a man of great loyalty, who inspired love and loyalty in his family, his friends, his patients and his pupils. Countless patients revered him; Lord Nuffield financed his concept of an 337 Who’s Who in Orthopedics that attracted him to the work of Lange and Vulpius on tendon transplantation in infantile paralysis. Studies of Tendon Repair Tubby was appointed senior demonstrator of physiology at Guy’s Hospital and while occupy- ing this post he carried out important researches on tendon repair, employing new staining methods he had learnt from Beneke of Brunswick. The Achilles tendons of full-grown rabbits were divided with antiseptic precautions, the punctures being protected with gauze. The animals were killed at intervals from 3 days up to 33 weeks, one at 13 months after tenotomy. His observations on the microscopic sections were reported in 1892 in the Pathological Society’s Alfred Herbert TUBBY Transcations and Guy’s Hospital Reports. In 1894, he was elected assistant surgeon to Alfred Herbert Tubby played a leading part in the Westminster Hospital and 4 years later became development of orthopedic surgery, particularly surgeon, an appointment he held for 30 years.

Albee more firmly convinced than ever before that in showed how the power-driven machine tools of many ways it was more important to restore a the mechanics’ trade could be used in bone patient to normal mental and spiritual health than surgery as precision instruments cheap urispas 200mg on line, thus increasing to physical health cheap urispas 200 mg overnight delivery, and that in so doing the patient tremendously the scope of orthopedics. With this must also be restored to his place in the economic system a new era of surgery commenced. From this experience came During 1912 Albee did many bone-graft Albee’s deep and lasting interest in rehabilitation experiments on dogs at Cornell University School as we know it today. He demonstrated to his own satis- were taught that their work was no longer con- faction that rigid cortical bone was much better fined to the sick room and the operating theatre, for transplantation than cancellous bone. Today but that it was related closely to the economic many think differently. He also showed that of all scheme of things in the very fabric of society the types of transplants, the autogenous graft had itself. In the field of so-called social orthopedics, the greatest measure of success. In 1912 he published his first work on bone Because of his keen interest, the first state reha- grafting in ununited fractures. It was in this type bilitation commission was established in New of surgery that his tools were most useful and Jersey in 1919. This was quite different from any in London, at the International Congress of Med- other type that had been done before. It was a V- icine at the Royal National Orthopedic Hospital, shaped fore-and-aft wedge. Albee felt strongly he demonstrated his bone-grafting techniques that, since one could not duplicate in the human with his motor-driven saw. In 1914, 4 months knee the normal gliding mechanism of the 6 Who’s Who in Orthopedics articular bone surfaces, a wedge type of arthro- plasty that provided both mobility and stability was to be preferred. As an interposing membrane in arthroplasties, he always used the facial fat graft advocated by Murphy. Winnett Orr, in Lincoln, NE, Albee became very much interested in osteomyelitis. He was convinced that the reason for the success of the closed plaster method of Orr in the infected com- pound fracture and the old osteomyelitic case was the spontaneous development within the host of a substance that thrived on virulent pathogenic bacteria and completely destroyed them. This substance, in 1921, had been called a “bacteriophage” by D’Herelle, of Yale. Albee was able to show a phage appearing in 94% of 100 cases of acute and chronic osteomyelitis. His Lewis ANDERSON treatment was to clean the infected material out of the wound completely and then inject a bacteri- 1930–1997 ophage solution into osteomyelitic wounds. In 1933 Albee described a rather ingenious Lewis Anderson was born in Greensboro, arthroplasty of the elbow in which, after he had Alabama, on October 13, 1930. He attended reconstructed the joint, he lengthened the olecra- Emory University in Atlanta from 1947 through non with its triceps attached—in some ways a 1949 and received his MD degree from the Uni- comparable operation with his kinesiology lever versity of Pennsylvania in Philadelphia in 1953. Anderson served In 1934 he became greatly interested in low- as an intern at the Hospital of the University of back pain. Myofascitis, he said, was the principal Pennsylvania in 1953 and 1954 and then began a cause. This he described as a low-grade inflam- residency in general surgery at the same institu- matory change in the muscles and the fascia, with tion. His training was interrupted by 2 years of the fascial insertions of the muscle to bone active duty in the United States Naval Medical becoming hypersensitive because of toxic inflam- Corps, during which he served as the senior matory or metabolic changes. His treat- subsequently completed his residency at the ment for this condition was, first, the removal Hospital of the University of Pennsylvania. He emphasized colonic received his orthopedic training at the Campbell irrigation and the introduction of Bacillus aci- Clinic in Memphis from 1957 through 1960. Truly, he was an out- ate professor, and, from 1971 to 1977, as Profes- standing personality in the most progressive era sor of Orthopedic Surgery at the University of orthopedic surgery of all time. He once wrote, of Tennessee Center for Health Sciences in “I have never liked looking back.