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The fluorescence of TB-cyclen (1,4,7,10-tetrabenzyl-1,4,7,10-tetraaza-cyclododecane) and its complexes with CuII, CdII, PbII, ZnII, HgII and AgI are reported in 50% (v/v) CH3OH/H2O. It appears, as supported by NMR studies, that the TB-cyclen undergoes slow protonation reactions in CH3CN with 0.01 M HClO4 present. The non-protonated TB-cyclen adopts the ++−− conformer that is sterically shielded from protonation and complex-formation, and the slow formation of the protonated forms of the ligand, and formation of the ++++ conformer, is required before complex-formation can occur. Strong emissions at 352 nm are oberved on formation of TB-cyclen complexes with CuII, CdII, PbII, but not with ZnII, HgII and AgI: it is suggested that these are exciplex emissions. The selectivity of the fluorescence of CuII with TB-cyclen compared to ZnII suggests that ligands of this type might be useful in sensing CuII in neural tissue, as in the case of studying Alzheimer’s disease, where potentially interefering metal ions such as CdII or PbII should not be present. The structure of [Pb(TB-cyclen)](ClO4)2 is reported, which shows that Pb···C π contacts are formed to all four N-benzyl groups. Structures of [Cd(TB-cyclen)CH3CN](ClO4)2 and [Hg(TB-cyclen)CH3CN](ClO4)2 are reported, that show M···C π contacts to only two of the N-benzyl groups, but the non-formation of four π contacts may be due to the presence of coordinated CH3CN molecules. The structure of [TB-cyclenH]ClO4 shows that the cyclen moeity of the ligand has the ++++ conformer required for complex-formation with metal ions. It is suggested that in the protonated forms of the free ligand, the ++++ conformer is stabilized with the N-benzyl groups in an upright position by the formation of N H···C π contacts, and C H···C π contacts between the upright N-benzyl groups. DFT calculations are carried out that show the structure of the exciplex that can be formed in the free (non-protonated) form of DB-cyclen, and show that its ++−− conformer is the lowest energy form.

Metal complexing and fluorescence properties of MB-cyclen (1-phenylmethyl-1,4,7,10-tetraazacyclododecane) and its complexes with metal ions in 50% CH3OH/H2O are described. The crystallographic structures of the complexes [(Zn(MB-cyclen))2OH](ClO4)3(2·13H2O), [Ag(MB-cyclen)(ClO4)], [Pb(MB-cyclen)(ClO4)2], [Hg(MB-cyclen)(ClO4)2], [Cu(MB-cyclen)(ClO4)2], and [Ni(MB-cyclen)(ClO4)2] are reported. The normal fluorescence peak of the benzyl group was observed at 289 nm and only the ZnII ion showed a strong CHEF (chelation enhanced fluorescence) effect for the 289 nm peak, which is in line with its lower position in the well-known order of ability to form fluorescence quenching π contacts: ZnII ≪ CdII

To evaluate accuracy in interpretation of shoulder magnetic resonance (MR) images and interobserver agreement and to characterize the types of errors.Five radiologists with varying experience independently and retrospectively twice interpreted the MR images of 222 symptomatic patients who underwent both MR imaging and shoulder arthroscopy. The first interpretation was a blind review; the second was with knowledge of the arthroscopic findings.For full-thickness tears, the sensitivity, specificity, and accuracy were 84%-96%, 94%-98%, and 92%-97%, respectively, and for partial tears, 35%-44%, 85%-97%, and 77%-87%, respectively. There was no statistically significant difference between readers in the detection of partial or full-thickness tears. There was a statistically significant difference between readers in the no-tear category. Cohen kappa values generally indicated improved interobserver agreement proportional to the readers' experience (full-thickness tears, 0.731-0.881; partial tears, 0.168-0.443).Diagnosis of a full-thickness tear can be learned to a high degree of accuracy. Despite the radiologist's level of experience and knowledge of the arthroscopic findings, the sensitivity for diagnosis of partial tears is poor.

This article reviews the applications of MR imaging of the patellofemoral compartment. Axial plane images are the most informative for abnormalities of this compartment. The role of MR imaging in the evaluation of the medial synovial plica and in the detection of chondromalacia is discussed. MR imaging can reliably detect and delineate the complex of injuries associated with patellar dislocations and valgus hyperextension.

Seventeen patients with patellar retinacular ligament injuries were evaluated with magnetic resonance (MR) imaging. MR findings were correlated with clinical, surgical, and arthroscopic findings. The injuries involved the medial retinacular ligament in 16 of 17 patients and the medial and lateral retinacular ligament in one patient. Nine of 17 patients showed MR evidence of a patellar dislocation. In these patients, a triad of findings that included focal impaction injuries involving the lateral femoral condyle, osteochondral injuries of the medial patellar facet, and injuries of the medial retinacular ligament were seen. Seven of the nine patients with patellar dislocation injuries had frank osteochondral injuries. The injured retinaculum had an indistinct, irregular appearance associated with edema and hemorrhage. The patellar dislocations were clinically unsuspected in the initial evaluation of eight of these nine patients. In eight of 17 patients, the mechanism of injury was a patellar tendon tear (n = 1) or valgus hyperextension (n = 7). In the seven patients with hyperextension injuries, three had associated meniscal and cruciate ligament tears. MR imaging can help define patellar retinacular and associated osteochondral injuries, which may be clinically useful information.

A statewide survey of home health care agency directors in Mississippi was conducted to determine the extent of Adverse Drug Reaction (ADR) monitoring and reporting by health care professionals. A 24-item questionnaire was sent to agency directors eliciting responses on agency characteristics, rate of occurrence of ADRs, and attitudes toward responsibility for monitoring ADRs. A total of 77 questionnaires were returned yielding a response rate of 48%. The average program enrolled 104 patients with 3.5 ADRs reported by health care professionals per year (range 0-65). Agency directors reported that physicians, nurses, pharmacists, and members of the pharmacy and therapeutics committee should monitor ADRs. Results indicated a need for all health-care professional involved in home health care to increase their ADR monitoring and reporting activities.

Proteins that are post-translationally modified by reactive oxygen and nitrogen species (ROS/RNS) have relevance to disease including cancer however, their study as a source of cancer biomarkers is still at a relatively early stage. Identifying these biomarkers in serum presents a difficult task given the vast range of protein concentrations. To alleviate this problem two enrichment strategies that precede analysis are emerging. The first is removal of high abundance proteins and the second, enrichment of the adducted proteins using immunopurification with antibodies developed against specific protein adducts. Using the latter approach, we isolated and identified four NT-containing proteins unique to the serum of breast cancer patients: obscurin, nucleoprotein, fibrinogen gar and fibrinogen bet. The potential impact of this work is that first, it provides a methodological template for the purification and further study of post-translationally-modified proteins and secondly, through the development of assays to monitor these biomarkers in the serum of cancer patients, it has the potential to present the physician an opportunity for more timely therapeutic intervention by providing improved diagnostic capability with use of early disease biomarkers. This should result in improving long term survival which is highly relevant to the goals of the Era of Hope.

Nuclear factor-kappaB (NF-kappaB) is a ubiquitous redox-sensitive transcription factor involved in the pro-inflammatory response to several factors, including cytokines and oxidative stress. Upon activation, NF-kappaB translocates into the nucleus and binds to specific nucleotide sequences. The cellular responses to inflammatory and stress signals have been implicated in disease conditions, such as atherosclerosis, cancer, diabetes, and Alzheimer's disease. The conventional method for detection of NF-kappaB -DNA binding activity is the electrophoretic mobility shift assay (EMSA), which is time-consuming and non-quantitative. Here, we report (a) development of a rapid, sensitive and quantitative chemiluminescent immunoassay (QCI) for analysis of NF-kappaB DNA-binding activity, and (b) validation of the QCI with the EMSA using nuclear and cytosolic extracts from cultured prostate cancer cells (PC3), rat liver homogenates and human lymphocytes. The QCI for analysis of NF-kappaB DNA binding activity has advantages over the EMSA: (1) Higher speed: 3-5h post sample preparation, (2) Greater sensitivity: 10pg NF-kappaB/well, (3) Quantitative: linear range: 10-1000pg NF-kappaB; r2 = 0.999 (4) High throughput adaptability: 96-well plate format can analyze up to 40 samples in duplicate, (5) SAFETY: No radioactive isotopes, (6) Simplicity, and (7) Capability of measurement of both activated (free) NF-KB which is translocated into the nucleus and total (bound + unbound) NF-kappaB present in the cytosol/cell.

Analysis of 20-hydroxyeicosatetraenoic acid (20-HETE), a potent vasoconstrictor produced by the cytochrome P450 pathway, presently requires high-performance liquid chromatography (HPLC) and gas chromatography/ mass spectrometry (GC/MS). To simplify 20-HETE analysis, competitive ELISAs were developed using polyclonal anti-20-HETE coated ELISA plates to which free 20-HETE and 20-HETE conjugated to horseradish peroxidase (HRP) or alkaline phosphatase (AP) were added. Assays were developed with and without a pro prietary enhancer solution which allows for the extraction-free measurement of 20-HETE in urine samples. The bound 20-HETE-HRP or 20-HETE-AP was detected using 3,3 ,5,5, -tetramethylbenzidine and p-nitrophenyl phosphate, respectively. Sensitivities expressed as 80% B/B0, were 0.1 ng/ml for the HRP assay, and 0 5 ng/ml for the AP assay, with r2 = 0 99 for both formats. Of the 17 lipids tested for cross-reactivity, arachidonic acid showed the highest (0.32%) followed by racemic 5-HETE (0.07%) and 8,9-dihydroxyeicosatrienoic acid (DHET) (0.04%). Preliminary validation experiments examining serum and urine concentrations of 20-HETE yield values that fall within the ranges established by GC/MS in the literature. These ELISAs provide simple and inexpensive methods for the analysis of 20-HETE in biological samples.

The reasons for time clock use in health-care institutions, the categories of workers required to use a time clock and other timekeeping methods, and the incidence of time-clock-related conflicts were studied. A questionnaire was mailed to a random sample of 565 hospitals in October 1989. Usable responses were received from 340 (60.0%) of the institutions. Reasons given for time clock use included payroll tabulation, overtime calculation, and ensuring fair payment. Thirty-four institutions (10.0%) required all employees to clock in, and 179 (52.6%) required some employees to do so. A written time card completed by the employee was the method used most frequently if a time clock was not used. Clinical pharmacists were required to clock in at 51 institutions (15.0%), staff pharmacists at 62 (18.2%), and pharmacy technicians at 144 (42.9%). Clinical nurse specialists and registered nurses clocked in at 88 (25.9%) and 169 (49.7%) hospitals, respectively, and licensed practical nurses and nurse's aides each clocked in at 176 hospitals (51.8%). Less than 6% of the hospitals required salaried pharmacists or nurses to use a time clock. Of the respondents, 152 (44.7%) reported that they were not aware of any conflicts or that no conflicts had been experienced. Inconvenience and inaccurate clocking were the most common sources of conflict cited. Most hospitals use time clocks for nonsalaried employees for bookkeeping purposes; dissatisfaction with this method of tracking hours worked does not appear to be widespread.

In Airborne Laser (ABL) like systems, the phase information is typically reconstructed from wavefront tilt sensor data using a least-squares approach. The solution to the phase reconstruction problem provides a smooth unwrapped phase surface that is not necessarily equal to the original wrapped phase surface in an optical propagation sense. Still, the computed phase surface furnishes information that can be used in determining the required phase conjugation for partial correction of an atmospherically distorted laser source. In this paper, we examine the effect of two phase reconstruction algorithms; unweighted least-squares and intensity weighted least-squares on the performance of an idealized ABL-like adaptive optics systems under ABL-like atmospheric conditions. The performance of each phase reconstruction algorithm will be investigated using MZA's Airborne Laser Simulation under atmospheres with Rytov numbers ranging from 0.233 to 3.725. Since the unwrapping process creates a phase surface without the 2(pi) discontinuities of the original phase, the r0 and phase variance can be calculated from the unwrapped phase. These predictors of the phase correlation performance will be related to the performance measures; Strehl and power-in- the-bucket at the target.© (1998) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

Popliteal muscle and tendon injuries are thought to be unusual. This report describes the magnetic resonance (MR) appearances of popliteus muscle and tendon injuries.The study included 24 patients where the diagnoses of popliteal injuries were prospectively made based on MR appearances. The study group was taken from 2412 consecutive knee MRIs. The injuries were characterized as to involving the muscular or tendinous portions of the popliteus apparatus.In 95.8% (23/24) of patients, the tears of the popliteus involved the muscular portion. The injuries were either partial and interstitial or complete. Three patients had tears of both the muscular and tendinous portions or the tendon alone. The anterior and posterior cruciate ligaments were torn in 16.7% (4/24) and 29.2% (7/24) of patients, respectively. There were medial and lateral meniscal tears in 45.8% (11/24) and 25% (6/24) of patients, respectively. There were injuries of the medial and lateral collateral ligaments in 8.3% (2/24) and 4.2% (1/24) of patients, respectively. Bone bruises and/or fractures were seen in 33.3% (8/24) patients. In 8.3% (2/24) of patients, the popliteus injury was an isolated finding.Popliteus muscle and tendon injuries are not uncommon. They usually occur in conjunction with other significant injuries of the knee and can be characterized with MR imaging.

Increased worldwide power demand, coupled with clean air requirements, has created a worldwide surge in single cycle and combined cycle Gas Turbine installations. These new Gas Turbines are often large megawatt facilities installed as base load units, which increases the need for component reliability. Today, high reliability in Expansion Joints can be achieved as a result of design criteria developed from new product components and in-service experience.Copyright © 1995 by ASME

This study explores student performance on a simple hands-on activity commonly referred to as “batteries and bulbs.” A large population of introductory calculus-based physics students formed the subject group. Special consideration was given to gender differences in success rates.

A table of literature citations designed to help hospital pharmacists develop a policy and procedure manual for i.v. admixture services is presented. The table is categorized according to literature that will aid in developing policies and procedures for specific aspects of admixutre services (e.g., distribution procedures, quality assurance). The citations were selected from two periodicals (American Journal of Hospital Pharmacy and Drug Intelligence & Clinical Pharmacy) and three other publications.

The objective of this study was to measure the quality of pharmaceutical services provided to hospital inpatients. Using Donabedian's model, normative standards from the Joint Commission on Accreditation of Hospitals and the American Society of Hospital Pharmacists were used to develop a personal interview schedule to access the structure and process components of pharmaceutical services. To determine the effect of bed size, rural vs. urban, and presence of a full- or part-time pharmacist on the quality of pharmaceutical services, three samples of short-term hospitals were drawn: a random sample of Mississippi hospitals with less than 100 beds; all Mississippi hospitals of 100 or more beds; and a sample of hospitals in Philadelphia, Pennsylvania. In each of the 112 hospitals a personal interview was conducted with either the chief pharmacist or the administrator responsible for the pharmaceutical service. The responses to the items were then tabulated and a structure and a process score were obtained for each hospital. The following conclusions can be made: (1) The quality of the "structural" components is positively related to the bed size and not to whether the hospital is located in a rural or urban setting; (2) the quality of the "process" components is related to both the bed size and the location of the hospital--hospitals having 100 or more beds or located in an urban area have a higher process quality than those having less than 100 beds or located in a rural area; and (3) hospitals employing a full-time pharmacist have a higher quality of care than those who do not.

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To summarize, we have been able to demonstrate: (1) In a case of acute trichinosis an extensive leucocytosis, with great absolute and relative increase in the number of eosinophilic cells in the blood, associated with a coincident decrease in the quantity of neutrophilic elements. (2) From the examination of specimens of muscle removed during life, besides the peculiar degenerations of the muscle, a longitudinal splitting of some of the fibres; a remarkable transverse splitting of others; a great proliferation of nuclei, about many of which vacuoles are seen; and large numbers of polymorphonuclear eosinophilic cells, which are especially prevalent in the more degenerated areas. (3) In a second case (after death), besides similar changes in the muscle, large numbers of eosinophiles throughout the infested portion. (4) In two other cases, during life, a great increase of the eosinophilic cells in the blood, with a coincident decrease of the polymorphonuclear neutrophiles, associated with leucocytosis, though of less extent than in the first case. (5) In pieces of muscle removed in these last two cases changes in most respects similar to those cited in the first case, but of less degree. (6) The similar character of the nuclei of the eosinophiles and the neutrophiles both in the blood and in the muscle, and the presence in the first case of certain cells which might be regarded as forms transitional between neutrophiles and eosinophiles, suggesting the possibility that the increase in the latter elements may, in these instances, take place in the muscles by direct transition from the neutrophiles.

In this paper I have tried to bring before you the results of my experience in this field, mycredo, if you will, and to ask you to share with me certain beliefs that have, through many years, gradually crystallized in my mind and which have helped me in my attempt to attack this very difficult problem in the way that is best for patient and for doctor. I am sure that it is wrong to consider the gall bladder as a separate entity and not as a part of the entire biliary tree, although in a considerable proportion of cases, the major portion of the pathology is concentrated there and it is in this group of cases where surgical attack upon the gall bladder is likely to be most successful. I am convinced that, in analyzing the symptoms, we must determine how many are referable to the gall bladder itself, how many to liver, ducts and biliary tract, for on the results of such analysis, must rest our decision as to medical or surgical treatment; and, if the latter is decided upon, what is the best operative procedure? I am quite convinced that cholecystectomy is the operation of choice in the vast majority of cases in which surgery is indicated, and, that in a good many of these cases, complete relief may be obtained by the removal of the gall bladder. I am equally convinced that where there is evidence of extensive liver and biliary tract infection as well, it is far wiser, if surgery is to be done, to employ cholecystostomy, possibly followed later by cholecystectomy or cholecystogastrostomy. I have touched upon the physiological basis for medical and dietetic treatment and its simplicity and its success in a fair number of chronic cases if carried out conscientiously, but I have tried not to over-emphasize its value because surgery must be utilized in most of the severe and many of the milder cases. Finally (for after all what is the value of treatment if diagnosis is not correct?), I have tried to preach the doctrine of thoroughness in reaching one’s final conclusions as to the underlying pathology: I have insisted upon the absolute necessity of a careful history of the case as well as the utilization of all the laboratory methods at our command. I have pointed out the difficulties in diagnosis in this field because of the striking tendency of the gall bladder to mirror symptoms due to disease elsewhere and in turn to be the cause of referred symptoms. To me, this will always be a fascinating field, a field beset with many difficulties, a field in which often we must grope rather blindly for a while, but one which I feel sure will become easier and easier of exploration if we attack each individual case thoroughly and scientifically—without prejudice and without bias—and if we try to learn as much, or more, from our failures than from our successes.

Nurses' attitudes toward three types of oral liquid unit dose packages--glass, plastic and aluminum--were determined. Thirty nurses who previously had not used unit dose packaging on their units were asked to evaluate the three types of packaging. The nurses preferred both aluminum and plastic over the glass containers; there was no significant difference in attitude toward the plastic and aluminum packages.

The performance of combustion-driven CO2 gasdynamic lasers (GDL's) was calculated and compared to experimental data for several gas mixtures produced by the combustion of different fuel/oxidizer combinations. The calculations were performed with a seven-temperature nozzle kinetics model which includes vibrational energy transfer processes involving ten combustion byproduct species. This model was used to analyze experimental results from a number of recent investigations which employed benzene and other liquid hydrocarbon fuels. The effects of large amounts of molecular O2 produced under oxidizer-rich combustion conditions were studied in detail. The calculated results agreed well with small signal gain data obtained for several fuels. The capability to make accurate predictions of the small signal gain for this wide range of gas mixtures and initial conditions makes this model useful in the design of optical resonators for GDL's.

Mandatory surgical exploration of penetrating renal injuries has been advocated for adequate assessment and repair of renal and retroperitoneal injuries. We evaluated 27 consecutive patients with deep stab wounds of the flank and back who were thought to be at risk for renal injury. Twenty-two patients were studied by CT, 11 by excretory urography, and three by angiography. No correlation was found between the presence and amount of hematuria and the extent of renal injury. Excretory urography was also of little use; the extent of renal parenchymal injury was underestimated, overestimated, or indeterminate in many cases. Computed tomography gave an accurate assessment of the extent of parenchymal damage, perirenal hemorrhage, extravasation of urine, and extrarenal injuries. Angiography was rarely required to better define renal vascular injuries. Only seven patients required surgical repair; the 20 patients managed nonoperatively included seven patients with renal lacerations considered minor by CT evaluation. We conclude that most patients with penetrating trauma do not require surgical exploration. The combination of clinical and CT criteria allows confident management in almost all cases. Computed tomography should be the primary diagnostic study in patients with penetrating back or flank trauma judged to be at risk for renal or other retroperitoneal injury.

Excerpt To the editor: We read with interest the article by Cooper and colleagues (1) on the usefulness of thyroxine treatment in certain patients with subclinical hypothyroidism. They studied pati...

Human prothrombin activation is unique in that, in addition to the release of fragment 1-2 (F1·2) from the NH-terminus of prothrombin by factor Xa during the generation of thrombin, an additional 13 residue polypeptide, fragment 3 (F3), is autocatalytically removed”from the amino-terminus of the thrombin A chain. We have developed a rapid radioimmunoassay for human F3 which incorporates short incubation times and the use of a preprecipitated second antibody; the assay can be performed in three hours. Specificity studies in buffer systems show prothrombin and prothrombin 1 cross-reacting at a level of 0.001; purified thrombin does not cross-react. In the presence of 5% BSA, prothrombin displays considerably less cross-reactivity. No immunoreactive material to F3 antibodies could be detected in 400of plasma. Serum, obtained from whole blood clotting, conr tained measurable quantities of F3 (40-100 ng/mL). This amount in serum represents on 5–10% of the theoretical amount available should all of the fragment be hydrolytically cleaved during the conversion of prothrombin to thrombin. This assay procedure Is currently being utilized to monitor the activation of purified human prothrombin in the absence and presence of selected plasma inhibitors. (Supported in part by NIH 05384-17 and the Michigan Heart Association).

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No subject in renal diseases has been more discussed than calculus, especially as regards the etiologic factors involved in the production of the stone. Many theories have been held regarding the origin of stone in nephrolithiasis, but of these most have been finally abandoned from insufficient evidence; thus the idea that telluric conditions play an important role in this connection has been practically abandoned by all, as also the belief that gout was the most important etiologic factor in the development of such a condition, while Senator, Von Noorden and numerous other observers have definitely shown that the method of living and the variety of diet play, speaking generally, but a small part. Our ideas regarding the formation of uric acid in the body have undergone a marked change, through the work of Horbaczewski and Kossel, who showed that in a large number of cases, at least, the uric acid

Excerpt The diagnosis of intra-abdominal pathology is extremely difficult. We have no method for exact diagnosis such as the electrocardiogram for the cardiac lesion, the blood in primary anemias, ...

Recently radium, its emanations and the products of its decomposition or breaking-down have been coming more and more into consideration as therapeutic agents, not only in skin diseases and diseases with cutaneous manifestations, but also in various "internal diseases" of the most diversified nature, especially carcinoma and the arthritides, and as this interest seems distinctly on the increase and there seems to be a real hope that in some, at least, of these diseases a cure may be obtained by this means, it would seem of interest to know the exact effect of certain salts or products of radium on those substances of such vital importance to the body metabolism — the ferments. As a slight contribution to this subject we have carried on a series of experiments on the effects of Radium-Lead, Radium D, E and F from radio-active ores, and Radium D, obtained from emanations, on certain of

Notwithstanding the increasing penetration of surgery into many other fields, cardiovascular, respiratory, renal, neural and endocrine, I feel sure that the digestive tract presents by far the most borderline problems, in which one must decide in each individual case whether surgical or nonsurgical treatment is the more likely to bring about cure or improvement. To operate or not to operate for peptic ulcer, gastric or duodenal, disease of the gallbladder, chronic appendicitis, cancer of the esophagus, stomach or small and large intestine or nonspecific ulcerative colitis—that is the question; and, if operation is decided on, when to operate, what operation to perform and who is to operate. On the proper answers to these questions depend in large measure the end results in each case. While the main purpose of this short paper is to discuss treatment, it is axiomatic that for the optimum results correct diagnosis or, at least, a

When one contemplates the marvelous change in the past twenty years in our knowledge of the diseases of the digestive apparatus and honestly tries to analyze what has been the fundamental cause of this change— this metamorphosis from poverty of method and uncertainty of result to our present wealth of diagnostic data and successful therapy—I feel that we must admit that it is to the surgeon and to the physiologist that this great change is mainly due. The use of the stomach tube has been an aid, and the more refined and newer methods of studying gastric and intestinal secretions have proved of interest; but an attempt to evolve a gastro-intestinal pathology fundamentally on the basis of secretory variations is to lean on a frail reed—and in the stomach the secretory findings must be regarded as but general indexes of the tendency of the functional digestive act rather than as

Excerpt I think we will all agree that the final aim of Medicine is the prevention or cure of disease—that our studies in gross and microscopic pathology, in bacteriology and in the ever-widening f...