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F.P. Retief 《CMAJ》1986,134(8):873-875
The traditional clinical method, which has served medicine well for over 100 years, had its origins in the integration of physical examination with morbid anatomy in early 19th-century France. Now this method is showing signs of failing to meet some contemporary needs. In particular, there is no means for understanding the inner experience of patients. Previous models of a transformed method have not grappled with the problem of validation. Data on the inner experience of patients are not open to empiric validation in the same way as clinical data. The process of understanding the meaning of an illness is not, therefore, scientific in the conventional sense. There are, none the less, rigorous methods for validating the results of this form of inquiry, notably those of phenomenology. A transformed method should aim to understand the meaning of an illness for the patient as well as provide a clinical diagnosis. The transformation will require a change in the epistemology of medicine and an educational process that encourages reflection and growth of self-knowledge.  相似文献   

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Short, “one-pot” syntheses of malondialdehyde adducts of deoxyguanosine, deoxyadenosine, and deoxycytidine are described. These syntheses proceed in improved yield and easier purification than previous syntheses and are well suited for the preparation of isotopically labeled nucleoside adducts for biomarker and metabolic studies.  相似文献   

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IN the course of experiments in which movements were elicited by direct electrical stimulation of the cerebral cortex, Graham-Brown1–4 and Sherrington5 found that, after each train of stimuli, there were prolonged changes in the excitability of the cortex. They showed that the motor responses of forelimb muscles in primates, even though elicited by identical cortical stimuli, could be extremely variable. Two of the phenomena they described in detail (see also Lilly6) were “facilitation” (the increased motor response resulting from a second train of stimuli when it was applied within 20 s after the first train) and “reversal of response” (when repeated, identical stimulation of the same cortical point elicited flexion instead of extension, or vice versa).  相似文献   

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Summary Dynamics of neuron ring has been studied by means of computer simulation. The ring is formed of some number of identical neurons which loop together with lateral inhibitions and are stimulated by a command neuron. In this model, we assumed that each neuron has individual activity intrinsically without any inputs. The function of each neuron is essentially the same as that of Reiss' model; each neuron receives one excitatory and two inhibitory signals and when the membrane potential exceeds the instantaneous values of threshold, the neuron fires and sends out signals. Fatigue effect is also introduced in this model; after firing, the threshold level rises up for a period. This report is mainly concerned with the mechanism by which the individual activities of each neuron transit into an ordered behavior as a whole when they are externally stimulated. Results can be summarized as follows: The individual random activities of neurons can be organized and transfered into an ordered behavior on a completely symmetrical neuron ring if externally stimulated and the following conditions are satisfied; 1. the individual inherent activity is within a moderate range, 2. the fatigue effect is large enough, 3. external stimulation is high enough and 4. neurons in the ring are laterally inhibited. The individual activity and the lateral inhibition are essential to generate a meaningful output pattern as a group and fatigue effect acts as a stabilizing factor of the generated pattern.  相似文献   

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The use of the data from various athletic sports for exercises in the interpretation of data is proposed, and accounts are given of two such exercises. The first looks at the relationship between time and distance in world records for men running. When the logarithm of the time is plotted against the logarithm of the distance a straight line is produced. Thefactors that govern the speeds at which various distances are run are discussed and the application of these to other sports and to animals other than man is briefly mentioned. The second exercise looks at anomalous performances by men running in the 1968 Olympic Games which took place at high altitude. It is shown that while the lowered air resistance increased the speeds in sprint events, and the lowered oxygen content slowed down speeds in long distance events, these were not the only factors involved in limiting speeds.

Among the advantages of the use of such data are that they are readily and easily available, that they are the result of a lengthy selection process involving many subjects, that they appeal to students interested in sport and that they can link courses in biology and physical education.  相似文献   

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