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Dissertations / Theses on the topic 'History of Surgery'
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Bilokon, N. O. "A brief history of plastic surgery." Thesis, Видавництво СумДУ, 2012. http://essuir.sumdu.edu.ua/handle/123456789/26010.
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Historically, plastic surgery have been practiced for thousands of years, going back to more primitive methods that were seen in India since around 800 B.C. At that time, plastic surgery procedures consisted of skin grafts that were performed on those that suffered from skin damaging injures. Ancient doctors developed methods to help suture the skin to the body, to help prevent scarring. They performed reconstructive operations on ears and noses that were lost in war or through punishment for a crime. The Romans were also practicing plastic surgery by the first century B.C. Their culture greatly admired the beauty of naked body thus promoting them to improve or eliminate the appearance of any bodily defect or deformity. Their procedures included breast reduction and scar removal.
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Kabbara, Sami. "History of Cataract Surgery: From Prehistoric to Modern Times." The University of Arizona, 2018. http://hdl.handle.net/10150/627030.
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Hanson, Christine Joan. "Clinical competency in oral surgery : history, challenges and solutions." Thesis, University of Dundee, 2015. https://discovery.dundee.ac.uk/en/studentTheses/71eba1df-fc6e-4418-ba06-3c3d829d1448.
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This multifaceted study documents validates, and verifies the changes in oral surgery teaching in Dundee University Dental School, which have changed with time to accommodate the demands of an ever increasingly complex discipline. Availability of instructive teaching material in hard copy and as video and text on the internet combined with close clinical supervision and detailed assessment with feedback allows students to attain competency in exodontia with falling patient numbers. It has been demonstrated that the undergraduate training in the oral surgery clinics still attains competency or BDS standard of ‘safe beginner’ for simple extractions and minor oral surgery, despite fewer procedures being carried out. The criteria used for undergraduate assessment and marking of exodontia have been validated in house and nationally. These are appropriate, objective and reliable. Using Thiel cadavers is a valid and reliable method of teaching undergraduate students the technique of extraction with forceps prior to their clinical exposure. Further employment of the cadavers for continuing practice and the introduction of new skills has been mooted. The use of the ‘Blackboard’ was investigated and found not to be well used; the effort to produce the work was not well directed since it was not taken advantage of by the whole year nor very frequently by those who do use it. Alternative methods of engaging the student to investigate and research the discipline have been suggested. Encouragement of the students to interact more when the exodontia clinic time is available for this opportunity has been introduced and suggestions to increase this activity to enhance the teaching of core topics have been made. From apprehension to enjoyment our student assure us that they find this discipline worthwhile whilst acknowledging that it will not be a practice builder and that they are equipped to deal with simple oral surgery procedures.
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Doyle, Julie. "Imag(in)ing anatomy : dissecting difference through the art of surgery." Thesis, University of Sussex, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.369583.
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This thesis locates contemporary conceptualisations of gendered embodiment as a particular effect of the historical projects of anatomy and surgery as they emerged in eighteenth century Europe. Dissection, as a practice of surgery, sought to define knowledge of the body through the isolation of its structures and parts. Disembodied matter was articulated as evidence of embodied knowledge - knowledge concerning notions of sexual and racial difference, inscribed through a surgical narrative. The operations of the surgical knife in the dissection and isolation of matter were thus implicated in the construction of anatomical knowledge through notions of cultural difference. Yet surgeons/anatomists were reliant upon artistic processes of representation in order to disseminate and make intelligible knowledge of anatomy. The language of surgery as a 'scientific' discourse of the body drew heavily upon the representational language of art during this period. The Enlightenment surgeon was presented primarily as an artist, represented through a gentlemanly discourse of the liberal arts and social progressiveness. Within the context of a scientific discourse of anatomy, the methods of surgery were likened to the creative processes of painting and poetry. The anatomical body, as the subject of the surgeon's inquiry, can therefore be interpreted as a specific medium of representation, interpreted according to aesthetic ideals. This thesis argues that the contemporary articulation of sexual and racial difference is one effect of the surgical isolation of anatomical matter. The surgical view of the body as an array of detachable and definable parts involved an imaging of these forms. Contemporary investment in narratives of gendered and raced embodiment can be understood as effects of the historical links between the theories and practices of the visual arts on the one hand, and an Enlightenment discourse of surgery on the other. This dissertation aims to assist a rethinking of that investment by revealing some of the historical and artistic processes by which the material body came to occupy its position as a privileged signifier of difference.
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Andréasson, Håkan. "Pseudomyxoma Peritonei : Aspects of Natural History, Learning Curve, Treatment Outcome and Prognostic Factors." Doctoral thesis, Uppsala universitet, Kolorektalkirurgi, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-197434.
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Pseudomyxoma peritonei (PMP) is a rare disease characterized by mucinous peritoneal metastasis (PM). Different loco-regional treatment strategies, i.e. debulking surgery and cytoreductive surgery (CRS) in combination with hyperthermic intraperitoneal chemotherapy (HIPEC), have changed the prognosis for these patients. CRS is an aggressive surgical procedure with a long learning curve. PMP exists in different types; how many depends on which classification is used. The aims of this thesis were to investigate the time-frame of PMP development from an isolated appendiceal neoplasm, examine the learning process for CRS, evaluate the differences in treatment outcome between debulking surgery and CRS in combination with HIPEC, to evaluate a more detailed PMP classification and to investigate particularly interesting new cysteine-histidine (PINCH) protein as a prognostic factor for PMP. Retrospectively 26 PMP patients were identified as having had an appendectomy with a neoplasm in the appendix but with no evidence of PM at the appendectomy. They were treated for PMP within a median of 13.1 months (3.8-95.3) after the appendectomy. No difference was seen between the types of PMP regarding the time to a clinically significant development of PMP and how much tumour was found at treatment. CRS is a highly invasive treatment and stabilization in the learning curve was seen after 220±10 procedures. Patients treated with CRS+HIPEC had a better 5-year overall survival (OS) than patients treated with debulking surgery, 74% vs. 40%. CRS increased the rate of complete cytoreduction from 25% in patients treated with debulking surgery to 72%. The new four-grade PMP classification showed very good inter-rater agreement between two independent pathologists and a difference in survival rates was observed between the different grades. A positive PINCH staining was recorded in 83% of the tumours and that was associated with poorer survival.
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Calabro, Cosimo. "Cosmopolitan anatomy and surgery in the age of the enlightenment: two poles in the career of Charles Nicholas Jenty." Thesis, McGill University, 2013. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=114426.
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This thesis addresses two specific moments in the professional career of the French surgeon and anatomist Charles Nicholas Jenty (?-at least 1777) whose biography includes long residencies in both England and Spain. While generally being studied in the context of the illustrations included in his anatomical atlases Jenty's biography and the extent of his scientific activities are marked by notable gaps. This thesis focuses on Jenty's membership in The Society for the Encouragement of Arts, Manufactures and Commerce and the chemical experiments he performed in London in 1761. It introduces for the first time in English an analysis of his surgical treaty published in 1766 in Spanish during his initial career in Spain. Finally, new biographical information is provided as a preliminary study for further investigation.Le présent mémoire porte sur deux moments concrets dans la carrière professionnelle du chirurgien et l'anatomiste Charles Nicholas Jenty (?-au moins 1777) dont la biographie comprend de longs séjours et en Angleterre et en Espagne. Bien que la vie professionnelle de Jenty a été étudié dans le contexte des illustrations qui font partie de ses atlas anatomiques renommés, sa biographie et l'étendue de ses activités scientifiques se distinguent par des lacunes notables. Le mémoire se concentre sur l'adhésion de Jenty dans la Society for the Encouragement of Arts, Manufactures and Commerce, et la réalisation de ses expériences chimiques en 1761 lorsqu'il se trouvait à Londres. Le mémoire présente pour la première fois en langue anglaise l'analyse de son traité de chirurgie publié en 1766 en langue espagnole au moment où il a débuté sa carrière en Espagne. De nouvelles informations biographiques sont également présentées dans le cadre d'une étude préliminaire qui mènera éventuellement à une étude plus approfondie.
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Jarman, Lisa Charlotte. "Galen in Early Modern English medicine : case-studies in history, pharmacology and surgery 1618-1794." Thesis, University of Exeter, 2013. http://hdl.handle.net/10871/15279.
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This thesis examines the influence of Galen (b. 129 AD) on medicine in England between 1618 and 1794, approaching the study of his authority and the use of his work through three case-studies: histories of medicine, pharmacology, and surgery. The histories of medicine illustrate the variety of ways in which Galen is referred to, both as a historical figure, and as an ongoing contemporary influence. His importance in terms of accessing the knowledge of the ancients, and as a fixed point in time around which to discuss the history of medicine, and to situate other practitioners over a broad time period, underlines the significance of his role within medicine. Similarly, the pharmacological texts examined provide a more tangible sense of the influence of Galen, and their varied, but formulaic structures enable specific remedies to be traced over time and their corresponding associations and details compared between different editions. Identifying the role of Galen within surgical treatises also allows for a more theoretical aspect of surgery to be explored, providing a different perspective on an area more frequently portrayed as a manual art. The use of Galenic texts within each case-study, in particular the histories of medicine, demonstrates a significant and nuanced engagement with the content of his works, reiterating the importance of his contribution, and showing the value ascribed to the simplicity offered by past approaches. It is evident that a shift had occurred from the acceptance of ancient authority based on convention, to evaluating the simplicity and utility of information on an individual basis. The value ascribed to utility in the assessment of medical knowledge is evident throughout these texts, which also demonstrate the importance of the experience and observations of the practitioner in facilitating the ongoing and significant use of the influence of Galen.
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Pollock, Alexander Chapman. "From dyspepsia to Helicobacter : a history of peptic ulcer disease." Thesis, University of Glasgow, 2014. http://theses.gla.ac.uk/5114/.
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This thesis is a historical study of peptic ulcer disease from the sixth decade of the eighteenth century until the end of the twentieth. Symptoms of dyspepsia or indigestion have affected more than twenty percent of the British population for most of that period and attracted the involvement of many medical practitioners and others with the provision of health care. Within this group of symptomatic dyspeptic patients were to be found gastric and duodenal ulcers which were capable of causing serious health problems. However the prevalence of stomach and duodenal peptic ulcers has declined markedly during the time course of this thesis and now they are relatively uncommon. Although peptic ulcers may still have a fatal outcome, they now are considered to be curable conditions for the majority of patients who suffer from them in the developed world. This thematic history of gastric and duodenal ulcer examines how medical practitioners worked in a changing climate of novel ideas about disease, often aided or driven by technological developments, from the nineteenth century onwards. It begins with a humoural approach to the understanding of disease, which concentrated upon a patient’s personality, lifestyle choices and circumstances but this was gradually displaced from the end of the eighteenth century by the clinico-anatomical approach, which sought to identify a specific lesion as the ‘seat’ of the disease. In the nineteenth century, the discoveries of pathology, physiology, chemistry and bacteriology became incorporated in clinical medical practice, involving the laboratory in the investigation and treatment of many diseases. In the twentieth century, medical research became rooted in experimentation using scientific technology and engineering to equip investigators with new methods which changed the ways in which diseases were understood and treated. Although there were many innovations in theoretical concepts of disease aetiology and empirical treatments, many were subsequently rejected for reasons of ineffectiveness or possible harm to the patient, sometimes after long periods of use. In its first part, the thesis draws upon publications from 1769 until 1950, mostly in the form of scientific articles and books. In the second part, the oral testimonies of health care professionals involved with the management and treatment of gastric and duodenal ulcers are added. The recorded testimonies of 28 witnesses have been preserved in written form as a supplement to this dissertation. Peptic ulcer disease was initially perceived as a whole-body ailment which was centred on the stomach as its symptomatic location and its treatment was intended to alter humoural imbalance or relieve symptoms. However after post-mortem examinations were increasingly performed from the seventeen-nineties, medical practitioners could see its complications in death and combine their findings with the clinical presentations of what was becoming recognised as a relatively common disorder. In the nineteenth century, physiologists investigated the workings of the stomach using vivisection and chemistry to analyse the stomach contents. The acid produced by the stomach was seen to play a part in ulcer genesis but there was no agreement as to what its precise contribution was for many years thereafter. Bacteriologists who found micro-organisms in the stomach assumed that they were pathogenically involved and subsequent experiments confirmed this. As a result of effective anaesthesia and antisepsis in the last decades of the nineteenth century, surgeons intervened increasingly in life-threatening complications of gastric and duodenal ulcers and their observations changed their perceptions of the diseases. In the twentieth century, opaque meal X-ray techniques began to allow doctors to see lesions inside the living stomach, as did improved endoscopes. In 1952, research suggested that stomach bacteria played no part in causing ulcers and further bacteriological research in the stomach was abandoned. By this time, surgeons had designed operations to reduce stomach acid production which healed most gastric and duodenal ulcers. Good therapeutic results were also achieved using medication and dietetic regimens, but it was recognised that only the surgeon could help patients who had failed to respond to medical treatments. In 1962 it was noted that deaths rates for gastric and duodenal ulcer were falling and fewer people were suffering from them, but they remained a serious cause of morbidity and mortality. A new acid-reducing operation was devised in 1969 that offered the hope that surgery could adequately treat ulcers without causing iatrogenic damage, and in 1976, a new drug was marketed which healed them if continuously taken. Then in 1983 it was asserted that peptic ulcers were caused by a bacterium which was later called Helicobacter pylori. In time and in the face of much opposition, it was shown that if this organism was eradicated in the stomach by medication then gastric ulcers and duodenal ulcers could be cured for the first time. This account of the history of peptic ulcer disease shows how medical practitioners adapted the theoretical basis of their medical practice as its evolved under the influence of scientific or societal changes and later abandoned concepts and therapeutic regimens which no longer were in accord with current thinking. Important issues which have arisen out of the testimonies include: medical involvement with the pharmaceutical industry, how doctors co-operate in the care of patients and how they respond to new theories and equipment and techniques as they became available. The history of peptic ulcer disease over the past two hundred years as described in this thesis follows a broadly similar course to that of other diseases such as tuberculosis, syphilis and chronic renal disease which once dominated the lives of those who suffered from them and have largely become curable in recent years. This thesis is offered as an account of an equally fascinating and complex disease.
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Browne, Jonathan Sebastian. "Contested care : medicine and surgery during the Spanish Civil War, 1936-1939." Thesis, University of Kent, 2017. https://kar.kent.ac.uk/61266/.
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This thesis traces the important role played by Spanish medical personnel, particularly surgeons, in the development and organisation of their own medical services during the Spanish Civil War. This study, therefore, is not strictly a history of medicine during the conflict, nor does it seek to further explore international efforts in this regard; rather it analyses through an examination of the medical personnel involved on both sides, the causes, treatments and long term consequences of injury and trauma, including that of exile, on the wounded of the Spanish Civil War. This thesis, by picking over the bones of a wide body of literature and by engaging with a variety of different sources, forms an interlocking part of a new historiographical strand examining the origins and evolution of a traumatic conflict whose repercussions continue to be felt throughout Spain. Through its engagement with a diversity of sources, its analysis of the relationship between medicine and propaganda, and through an inclusive examination of the contribution made by Spanish medical professionals across Spain during the Spanish Civil War and its aftermath, this thesis provides its own unique historical perspective of a conflict whose living legacy of trauma and of wounds unhealed is still alive in Spain today.
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Rouah, Fabrice. "The natural history of multiple sclerosis : a review of current modelling approaches /." Thesis, McGill University, 1997. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=20852.
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The highly varying course of MS has made it difficult to establish accurate prognoses about its natural history. The reliability of neurologic impairment grades obtained by clinical examinations of patients is becoming recognized as important. Current statistical methods in natural history studies of MS are essentially classical survival and linear models, applied to clinical data and with mortality, impairment, and secondary progression of MS, as outcomes. However, more sophisticated modelling attempts, in particular ones that account for the fluctuating course of MS, are rare. Stochastic and time series models are two such recent methods that have been proposed. As more complex statistical models are being called upon, it is crucial that practitioners consult with statisticians to ensure that the models are being correctly selected, applied, and interpreted.
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Firth, Clare. "Consideration of the option of prophylactic mastectomy by women with a family history of breast cancer : client's and physicians' views on decision making, information and communication." Thesis, Bangor University, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.367401.
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Qualmann, Krista J. "Examining the Pediatric Epilepsy Surgery Population: The Prognostic Value of Central Nervous System Comorbidities in Probands and their Families." University of Cincinnati / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1396524075.
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Skuse, Alanna Dawn. "'My breast is unquiet' : constructions of cancer in Early Modern England, c.1580-1720." Thesis, University of Exeter, 2013. http://hdl.handle.net/10871/14987.
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This thesis examines the construction of cancerous disease in medical and literary texts from 1580 to 1720. I contend that previous readings, which have viewed ‘cancer’ and ‘canker’ as words designating a wide variety of ulcerative diseases, are incomplete. Though terminology for the disease is sometimes challenging, I argue that early modern people clearly understood cancer as a pathologically unique disease, which was both fascinating and fearsome. Cancer was believed to be caused by surfeit of the melancholy and choleric humours. In part because of this aetiology, it was strongly associated with women. At the same time, however, medical and literary writers spoke of cancer in zoomorphic terms, and constructed the disease as deliberately cruel and intractable. Viewed alongside cancer’s famously morbid effects upon the body, this duality made cancer a powerful (and as yet unstudied) analogy for traitorous and malignant influences in the social and politic body. In turn, rhetorical uses of ‘cancer’ influenced how the disease was presented in medical and scientific writing. Cancer’s seeming hostility to the body also encouraged medical practitioners to develop, and patients to demand, treatments for the malady which trod a thin line between healing and hurting. Physicians, apothecaries and irregular practitioners administered increasingly potent pharmaceuticals, which moved away from traditional methods of redressing an individual’s unbalanced humours, and instead emphasised the importance of ‘defeating’ this enemy, even at great physical and emotional cost to the patient. Even more hazardously, surgeons carried out invasive and dangerous cancer operations, which could save lives, but which equally provoked angry debate over moral responsibility in the crowded medical marketplace.
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Shen, Wen T. ""Operating on shadows": Evolving perceptions of the incidentally discovered adrenal mass, 1982--2002." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2009. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:1465493.
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Coughlin, Deborah Ann 1953. "Fitting the school to the child: A case history of a child returning to school from brain surgery, radiation, and chemotherapy." Diss., The University of Arizona, 1997. http://hdl.handle.net/10150/282307.
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This ethnographic, teacher research case study focuses upon Valerie Clarie's return to school after surgery from brain cancer, radiation therapy and chemotherapy. Situated in a whole language classroom, Valerie is entering her fifth year of school in a southwest public school system. Prior to this study, Valerie was placed in a traditional classroom setting receiving services on a pull-out basis from the special education resource teacher. This study was initiated during an attempt to mainstream Valerie into her whole language classroom on a full-time basis. It critically examines Valerie Clarie's special education and whole language classroom settings and curriculum. Utilizing work samples, journals, medical records, and school records, this study questions the appropriateness of each of these settings for Valerie, and seeks to discover which setting supports Valerie best in her academic and social pursuits. The study is additionally concerned with identifying Valerie's strengths as a learner. These strengths are documented and maintained using alterative assessments utilized in her whole language classrooms. Additional topics addressed in this study include issues of literacy, social structures of school, hegemony, special education curriculum, whole language curriculum, standardized testing, and brain cancer.
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Folk, Holly. "Vertebral vitalism American metaphysics and the birth of chiropractic /." [Bloomington, Ind.] : Indiana University, 2006. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3223040.
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Thesis (Ph.D.)--Indiana University, Dept. of Religious Studies, 2006."Title from dissertation home page (viewed June 26, 2007)." Source: Dissertation Abstracts International, Volume: 67-06, Section: A, page: 2291. Adviser: Stephen J. Stein.
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Futterer, Patricia. "Cultural studies of science : skinning bodies in Western medicine." Thesis, McGill University, 1995. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=23332.
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This thesis explores the cultural implications underlying the medical practice of cutting human flesh. The examination focuses, in particular, on the function of representational technologies--from anatomy sketches to computer imaging--in the scientific understanding of the body in the West. By foregrounding the technologies of representation which inform and have directed a history of surgery, it is hoped that the cultural aspects of modern medicine will be made apparent. This thesis argues that while science benefitted from art to construct its image of 'the' body, it has had to rid itself of art in order to justify its empirical claims. The study concludes with a discussion of the work of the French performance artist Orlan who uses plastic surgery in a performative setting to deconstruct these very claims.
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Gupta, Nishant. "The NHLBI Lymphangioleiomyomatosis (LAM) Registry: Longitudinal Analysis to Determine the Natural History of LAM." University of Cincinnati / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1504879473662385.
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Yazdani, Anuschirawan. "The professional and personal impact of the Australian and New Zealand comprehensive gynaecological surgery training program on specialists in training and third-party stakeholders." Thesis, Queensland University of Technology, 2022. https://eprints.qut.edu.au/235134/1/Anuschirawan_Yazdani_Thesis.pdf.
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This research explores why specialists undertake further training in advanced gynaecological surgery, how and why such training pathways develop and how they are regulated.
This research advocated for the acceptance of alternative training pathways and shaped postgraduate medical education and workforce planning.
Through a mixed-methods approach, this thesis constructs a historical timeline as the foundation for a critical analysis of the professionalization of operative gynaecology and establishes the main reasons for advanced training as the development of surgical competency, recognition, certification, and involvement in academic activities, emphasizing the training unit, surgical case load, a structured curriculum and peer group.
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Kennedy, Laura. "'Carry not a picke-tooth in your mouth' : an exploration of oral health in early-modern writings." Thesis, Loughborough University, 2012. https://dspace.lboro.ac.uk/2134/10976.
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This thesis is an exploration of various aspects of oral health in the early-modern period. It examines evidence taken from texts belonging to a range of genres including surgical manuals, botanical texts, midwifery manuals, poets and plays. Building on existing academic work relating to the history of dentistry and venereal disease, it aims to assimilate material from across science and the arts in order to gain a sense of what general social expectations were in relation to the condition of the teeth and palate, and how people suffering with a decline in oral health were advised, or what treatments were available to them either from a professional or in the home. It aims to challenge existing preconceptions that people living in this period displayed a negligent attitude towards the health of their teeth and oral hygiene. The thesis contains four chapters which each focus on a different aspect of oral health, though many themes recur across all four chapters. The first chapter investigates advice that was available in print, and therefore likely to be in public consciousness, to the early-modern individual in relation to maintaining their teeth. It then considers the portrayal of unattractive teeth and bad breath in early-modern literature. Chapter Two deals with early-modern explanations of what caused the toothache and how it could be remedied. Analysis of the depictions of toothache in various poetry and plays follows in order to explore how wider society made sense of medical thinking at the time. The palate becomes the sole focus of Chapter Three, which considers what specific health concerns posed a threat to the condition of the roof of the mouth, and what difficulties could arise for the individual whose palate has been damaged by disease or injury. The thesis concludes with a chapter which investigates the history of a congenital oral birth defect, the cleft lip and palate. The thesis was designed to allow each chapter to deal with a separate facet of oral health; they encompass in turn: oral hygiene, dental pain, the impact of disease on the palate and an exploration of an oral birth defect. An undercurrent of the thesis is to use a range of material to ascertain a realistic idea of what it was like for an individual to experience oral health difficulties in this period. It is therefore interested in how society perceived people who were experiencing problems with their oral health, and what could be done to improve their quality of life. The research presented here represents a contribution to the field of the history of oral health and aims to provoke further questions relating to the responsibility early-modern individuals took for their own oral health, and the specific situations in which intervention, either surgical or medicinal, was deemed necessary.
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Lana, Vanessa. "Uma associação científica no interior das Gerais: a Sociedade de Medicina e Cirurgia de Juiz de Fora (SMCJF) - 1889-1908." reponame:Repositório Institucional da FIOCRUZ, 2006. https://www.arca.fiocruz.br/handle/icict/4000.
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Colman, Ruben J. M. D. "The Natural History of Infliximab Immunogenicity and the Effect on Pharmacokinetics and Clinical Outcomes: A Prospective Pediatric Crohn Disease Cohort Study." University of Cincinnati / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1623239846522151.
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Boland, Paul William. "Morphometric analysis of data inherent in examination by magnetic resonance imaging : importance to natural history, prognosis and disease staging of squamous carcinoma of the oral cavity." Thesis, University of Oxford, 2010. http://ora.ox.ac.uk/objects/uuid:934e1e5a-24db-40ab-ab54-5e58901a9c2a.
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Magnetic resonance imaging plays an important yet underutilized role in determining the natural history and prognosis of oral carcinoma. Depth of tumour invasion is an emergent factor in the oral cancer literature. However, problems exist with the definition of cut-points suitable for inclusion in TNM staging criteria. Statistical methodology represents a possible explanation but is underexplored. In this work, a review of the depth of invasion literature is conducted with emphasis on statistical technique. As well, statistical simulation is used to explore the implications of the of the minimum p-value method. The results demonstrate that the use of continuous variable categorization and multiple testing is widespread, and contributes to cut-point variability and false-positive tests. Depth, as a predictor of OCLNM and survival, must be questioned. The volume of tumour invasion is a promising prognostic factor that has not been fully investigated in the oral carcinoma literature. In this work, the volume of tumour invasion is measured on MRI and compared to thickness and maximum diameter in its capacity to predict 2-year all-cause, disease-related and disease-free survival, as well as occult cervical lymph node metastasis prediction. As part of a comprehensive approach, morphometric factors are incorporated into multifactor predictive models using regression, artificial neural networks and recursive partitioning. It is evident that MRI-based volume is superior all other linear measurements for both occult cervical lymph node metastasis and survival prediction. Artificial neural networks wee superior to all other techniques for survival prediction. There is a case for a unified artificial neural networks model for survival prediction that uses volume, midline invasion and N-stage to determine prognosis. This model can be used to determine individualized probabilities of 2-year survival. The lateral extrinsic muscles of the tongue lie just beneath the surface of the lateral tongue, yet their invasion is a criterion for T4 classification using the TNM staging system. In this work, the Visible Human Female is used to conduct an anatomic study of the extrinsic muscles of the tongue. Linear measurement is used to quantify the distance from the surface mucosa to the most superficial muscle fibres of the styloglossus and genioglossus. Further, the lateral extrinsic muscles are poorly demonstrated on MRI. An anatomic atlas of the tongue is fused with MRI images of oral carcinoma to demonstrate lateral muscle invasion. The results demonstrate that the styloglossus and hyoglossus lie very close to the surface of the lateral tongue, in some cases passing within 1 mm of the surface mucosa. These extrinsic muscles are readily invaded by even small tumours of the lateral tongue. Strict application of the TNM T4a criteria leads to unnecessary upstaging as these carcinomas do not warrant the prognosis and aggressive treatment of Stage IV disease. Extrinsic muscle invasion should be removed as a T4a criterion for the oral cavity. A separate category, T4a (oral tongue) specifying invasion of the genioglossus is also recommended. This work presented in this thesis is an original contribution to the field of oral cavity cancer research and has determined that there is capacity for improvement in current efforts to determine the natural history and prognosis of oral cavity squamous cell carcinoma. This thesis is the first to examine the role of statistical methodology in oral carcinoma depth of invasion cut-point variability. Further, this work presents an original approach to the prediction of regional metastasis and survival using advanced multivariate modeling techniques. No other work explored MRI-measured volume using the substantial sample size gathered in this thesis. Finally, this work is the first to demonstrate that lateral extrinsic muscle invasion is an unnecessary component of the T4a (oral cavity) classification criteria and should be reconsidered.
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Andrén, Ove. "Natural history and prognostic factors in localized prostate cancer." Doctoral thesis, Örebro University, Academy of Health Science, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-2109.
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The natural history of localized prostate cancer is not fully understood. In most patients the tumor will never progress to a lethal disease, while a subset of patients will ultimately die of the disease. Efficient tools to separate indolent from lethal disease is currently lacking which means that many patients will be offered treatment without any benefit, but still be at risk of experiencing treatment related side effects.
The aims of these studies were to get more insight into the natural history of untreated localized prostate cancer, to assess the prognostic value of established clinical parameters such as Gleason score, nuclear grade and tumor volume and, moreover, some new prognostic markers Ki-67, AMACR and MUC-1. We also aimed to study time trends in the detection of incidental tumors in Sweden.
Patients with localized disease (n=223) and no initial treatment were followed for 21 years. Most patients had a favorable outcome. However, a subset of patients developed lethal disease even beyond 15 years of follow-up and these patients define the group that may benefit most from treatment with curative intent. Patients with poorly differentiated tumors experienced a 9 time higher risk of dying in prostate cancer.
The studies on prognostic markers are based on a cohort of patients (n=253) with incidental prostate cancer detected by transurethral resection for presumed benign hyperplasia. All patients were left without initial treatment. Gleason grade, nuclear grade and tumor volume turned all out to be independent prognostic factors. MUC-1, AMACR and Ki-67 also carried prognostic information. However, after adjustment for Gleason grade, nuclear grade and tumor volume only MUC-1 and AMACR remained as statistically significant prognostic factors. When tested for sensitivity and specificity they all failed and, consequently, they seem to be of less value in daily practice for cancelling an individual patient regarding the choice of treatment.
Time trends in incidental prostate tumors in Sweden were analyzed in a cohort of patients with prostate tumors detected by transurethral resection (TUR-P). Through linkage of the national registration number (NRN) with several registers, e.g. the Swedish Cancer Registry, the National Inpatient registry and the Cause of Death Registry we identified, during the period 1970 through 2003, in total 23288 patients with incidental prostate cancer, who constituted the study group. As comparison group we choose all patients diagnosed with prostate cancer between 1970-2003 excluding those with incidental cancer, in total 112204 patients. Our result confirms earlier findings that there has been a dramatic change over time in incidence of incidental prostate cancers in Sweden, which parallels the introduction of prostate specific antigen. We also found that the cumulative incidence of prostate cancer death is high in the incidental group, opposing earlier findings that incidental tumours are a non-lethal disease.
issn 1642-4063
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Heifferon, Barbara Ann. "Look who's not talking: Recovering the patient's voice in the clinique." Diss., The University of Arizona, 1998. http://hdl.handle.net/10150/282598.
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Almost everyone agrees that doctors' handwriting is not the only indecipherable and alienating communication practice in healthcare. The oral communication between doctors and patients is equally problematic. Few scholars in the field of rhetoric have attempted to analyze why and how these discursive practices have come about. Equally absent from the medical and rhetorical fields are alternative models that construct a better discourse between doctors and patients. My dissertation, Look Who's Not Talking: Recovering the Patient's Voice in the Clinique, not only examines how doctors talk to patients, but also begins an effort to change present discursive practices in healthcare. Michel Foucault began an academic conversation in The Birth of the Clinic and in Power/Knowledge that deconstructed certain institutionalized discourses. While his study went a long way toward analyzing the discourse of medicine, his language and theories have not moved into medical journals or patient rooms. My dissertation acts as a bridge between "high" rhetorical theory and the "marketplace" of medicine (an unfortunately apt metaphor for healthcare in this country). Foucault supplies one of the lenses I use to look at the discourse. Other lenses include those of Kenneth Burke and Lloyd Bitzer. One underlying assumption in the dissertation is that practices are more easily changed once they have been analyzed. I place the analysis within history and within current contexts. This strategy enacts a model opposing the usual acontextualized, ahistoric doctor/patient discourse. Both chapters 3 and 4 look at how doctor/patient discourse was constructed in Europe and America. In addition to making a contribution to the medical field, this dissertation breaks new ground within rhetoric and lays the basis for further explorations. Because of my extensive work in the healthcare field as cardio-pulmonary technician and special procedures nurse, I was able to draw on my own experience to use as examples of the particular problems within the discourse I isolate and propose alternatives to. The fifth chapter features a two-semester course I designed for first-year medical students. This course is rhetorically based and teaches doctors-to-be why the language they use with patients is important and how to effectively address patients.
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Васильєв, Костянтин Костянтинович, Константин Константинович Васильев, and Kostiantyn Kostiantynovych Vasyliev. "Хирург Александр Федорович (Исаак Юфудович) Дуван-Хаджи. К истории высылки 1922 года." Thesis, Издательство СумГУ, 2010. http://essuir.sumdu.edu.ua/handle/123456789/7520.
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Nero, Julie. "Hannah Hoch, Til Brugman, Lesbianism, and Weimar Sexual Subculture." Case Western Reserve University School of Graduate Studies / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=case1347561845.
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Serna, Elodie. "Faire et défaire la virilité. Les stérilisations masculines volontaires en Europe dans l'entre-deux guerres." Thesis, Lille, 2018. http://www.theses.fr/2018LIL3H002.
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Depuis l’exploration naissante de l’économie endocrine du masculin jusqu’aux opérations de revitalisation pratiquées dans les années 1920 et 1930, cette thèse montre de quelle manière diverses opérations génitales, dont la vasectomie, participent des stratégies médicales de construction du masculin. En parallèle, la stérilisation masculine volontaire est explorée dans le cadre de projets eugénistes à partir d’une campagne pour la légalisation de la stérilisation en Grande-Bretagne, de débats au sein de la Ligue mondiale pour la réforme sexuelle et du mouvement néo-malthusien français. L’évolution des normes de masculinité et de paternité est enfin questionnée par le recours à la vasectomie comme moyen contraceptif de convenance. L’organisation de vasectomies clandestines, la répression et la réprobation sociale qu’elles suscitent interrogent la disposition de soi du côté des hommes et le rôle normatif de! la procréation. Le caractère polysémique des stérilisations permet ainsi d’explorer globalement les reconfigurations de la masculinité à une échelle transnationaleFrom the nascent exploration of the endocrine system of the male to the revitalization operations performed in the 1920s and 1930s, this thesis shows how various genital operations, including vasectomy, contribute to medical strategies for the construction of masculinity. In parallel, voluntary male sterilization is explored in the context of eugenicist projects on the basis of a campaign for legalizing sterilization in Great Britain, the debates within the World League for Sexual Reform and the french neo-malthusian movement. The evolution of the norms of masculinity and paternity is finally questioned by the use of vasectomy as a convenient contraceptive method. The organization of clandestine vasectomies, the repression and social disapproval they generate question men's self-determination and the normative role of procreation. The polysemous nature of sterilizations thus makes possible the overall exploration of the reconfigurations of masculinit! y on a transnational scale
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Wang, Audrey Hongjun. "Histone deacetylase 4 is a transcriptional corepressor regulated by nucleocytoplasmic shuttling." Thesis, McGill University, 2003. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=19445.
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Histone acetylation plays an important role in regulating chromatin structure and thus gene expression. Analysis of histone deacetylase (HDAC) activity in S. cerevisiae revealed the presence of two deacetylase complexes, one containing Hda1 as its catalytic subunit, and the other possessing Rpd3. The three previously identified human HDAC proteins, HDAC1-3, were found to be homologs of Rpd3. This observation suggested that mammalian cells might contain an uncharacterized class of biochemically distinct Hda1-like proteins. The goal of my project has been to identify and characterize mammalian HDAC proteins which are similar to Hda1. I first identified the human histone deacetylase HDAC4, which contains a carboxy-terminal region significantly similar to the catalytic domain of yeast Hda1. When tethered to a promoter, HDAC4 functions as a transcription corepressor. Furthermore, HDAC4 interacts with the transcription factors MEF2 and RFXAf\lK and represses transcription of their target genes, supporting the notion that HDAC4 is a transcription corepressor in vivo. Surprisingly, HDAC4 is localized mainly in the cytoplasmic region and shuttles between the nucleus and the cytoplasm. Nucleocytoplasmic shuttling of HDAC4 is controlled by multiple mechanisms. HDAC4 possesses a nuclear localization signal (NLS) and a nuclear export signal (NES) for its dynamic nucleocytoplasmic trafficking. Binding of 14-3-3 proteins exposes the NES of HDAC4, which then results in its nuclear export. From this work, I have identified HDAC4 and shown that it functions as a transcription corepressor whose activity is regulated by nucleocytoplasmic shuttling.
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Nilsson, Ulrika. "Kampen om Kvinnan : Professionalisering och konstruktioner av kön i svensk gynekologi 1860-1925." Doctoral thesis, Uppsala University, Department of History of Science and Ideas, 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3836.
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This thesis investigates how gynaecology was established as a medical speciality in Sweden in the 1860s and onwards. Gender, power, professionalisation and the production of scientific knowledge are central themes. While previous research has shown that gynaecology as a discipline depends upon notions of Woman as radically different from Man, I show how this was manifested within Swedish gynaecology, an initially all male environment. Of special interest is institutionalisation, early career-paths and the development of therapy methods and theory. I argue that gynaecology reproduced and contributed to notions of sex-difference and a gender complementary way of thinking.
While gynaecology was formed as a surgically interventionist speciality with strong manly connotations, an education reform aiming at opening higher education to women was simultaneously discussed and eventually carried out during the 1860s and 70s. The advocates of this reform portrayed women as especially fit for becoming teachers and physicians, particularly treating women and children. Thus, two opposing gendered professional ideals operated. By focusing an elite group of early women physicians, I outline how the gynaecological construction of womanliness related to women physicians and how women physicians engaged with this notion: what strategies they used to enter a profession as manly as gynaecology had become; and how women gynaecologists engaged with their men colleagues’ therapeutic methods and views on patients and women.
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Ellis, Jonathan. "Examining a role for histone deacetylase inhibitors as immunosuppressants in organ transplantation." Thesis, University of Birmingham, 2016. http://etheses.bham.ac.uk//id/eprint/6987/.
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Current transplant immunosuppression regimens have numerous limitations. Recent evidence suggests histone deacetylase inhibitors (HDACis) may represent a class of drug with immunosuppressive properties. This study initially assessed a panel of experimental and established HDACis, identifying a novel HDAC6-specific inhibitor (KA1010) to compare with cyclosporin and the pan-HDACi suberoylanilide hydroxamic acid in models of alloreactivity. Proliferation and MLR-based assays were used to determine the immunosuppressive effect of compounds, and a murine model of allogeneic skin transplantation was adopted to assess the in vivo effects of HDAC6 inhibition. KA1010 displayed superior inhibitory effects on the activation of PBMCs using in vitro models of transplantation. In a one-way MLR, KA1010 (5μM) reduced parent cell proliferation from 92% to 64% (p=0.001). A two-way MLR, adopting IFN-γ production as a marker of alloresponse, resulted in up to 91% reduction. Dose-response curves revealed dose-dependent profiles with a greater potency of HDACis over CyA. Mice treated with KA1010 displayed no significant features of skin allograft rejection upon histological analysis at 70 days and graft survival of upto 80%. Immunological assessment, revealed a significant increase in regulatory T cells (from 18% to 25%, p=0.0002) and a corresponding reduction in CD4\(^+\) T cells (from 58% to 42%, p=0.0009). HDAC6 may represent an optimal target for future immunosuppressant therapeutics with a particular role in transplantation. In this thesis, we have demonstrated a superior immunosuppressive effect of KA1010 over both CyA and SAHA, in the models of allotransplantation adopted.
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Wilson, Philip Kevin. "Surgeon #turned' physician : the career and writings of Daniel Turner (1667-1741)." Thesis, University College London (University of London), 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.336480.
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Viberga, Ilze. "The Clinical Appearance of Pelvic Inflammatory Disease in Relation to Use of Intrauterine Device in Latvia : A Study with Special Emphasis on Factors Influencing the Clinical Course of PID in IUD Users." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-6458.
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Carlsson-Hyslop, Anna. "An anatomy of storm surge science at Liverpool Tidal Institute 1919-1959 : forecasting, practices of calculation and patronage." Thesis, University of Manchester, 2011. https://www.research.manchester.ac.uk/portal/en/theses/an-anatomy-of-storm-surge-science-at-liverpool-tidal-institute-19191959-forecasting-practices-of-calculation-and-patronage(db3ce0d8-2599-484c-8db1-a7a0488414a0).html.
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When the effects of wind and air pressure combine with a high tide to give unusually high water levels this can lead to severe coastal flooding. This happened in England in early 1953 when 307 people died in the East Coast Flood. In Britain today such events, now called storm surges, are forecast daily using computer models from the National Oceanographic Centre in Liverpool, formerly the Liverpool Tidal Institute (TI). In 1919, when TI was established, such events were considered unpredictable. TI's researchers, Joseph Proudman (1888-1975), Arthur Doodson (1890-1968), Robert Henry Corkan (1906-1952) and Jack Rossiter (1919-1972), did much mathematical work to attempt to change this. In 1959 Rossiter published a set of statistical formulae to forecast storm surges on the East Coast and a national warning system was predicting such events using these formulae. At this point TI believed they had made surges at least as predictable as they could with their existing methods. This thesis provides a narrative of how this perceived rise in the predictability of surges happened, analysing how TI worked to achieve it between 1919 and 1959 by following two interwoven, contingent and contested threads: practices of calculation and patronage. A key aspect of this thesis is the attention I pay to material practices of calculation: the methods, technologies and management practices TI's researchers used in their mathematical work on storm surge forecasting. This is the first study by historians of oceanography or meteorology that pays this detailed level of attention to such practices in the construction of forecasting formulae. As well as using published accounts, I analyse statistical research in the making, through notes, calculations, graphs and tables produced by TI's researchers. They used particular practices of calculation to construct storm surges as calculable and predictable scientific objects of a specific kind. First they defined storm surges as the residuals derived from subtracting tidal predictions from observations. They then decided to use multiple regression, correlating their residuals with pressure gradients, to make surges predictable. By considering TI's practices of calculation the thesis adds to the literature on mathematical research as embodied and material, showing how particular practices were used to make a specific phenomenon predictable. I combine this attention to mathematical practice with analysis of why TI's researchers did this work. US historians have emphasised naval patronage of physical oceanography in this period but there is very little secondary literature for the British case. The thesis provides a British case study of patronage of physical oceanography, emphasising the influence on TI's work not only of naval patronage but also of local government, civil state and industrial patronage. Before TI's establishment Proudman argued that it should research storm surges to improve the Laplacian theory of tides. However, when the new Institute received patronage from the local shipping industry this changed and the work on forecasting surges was initially done as part of a project to improve the accuracy of tidal predictions, earning TI further patronage from the local shipping industry. After a flooding event in 1928 the reasons for the work and the patronage again shifted. Between then and 1959 TI did this work on commission from various patrons, including local government, civil state and military actors, which connected their patronage to national debates about state involvement in flood defence. To understand why TI's researchers worked on forecasting surges I analyse this complex mix of patrons and motivations. I argue that such complex patronage patterns could be fruitfully explored by other historians to further existing debates on the patronage of oceanography.
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Zirkle, Dexter. "The Development of the Anterior Inferior Iliac Spine: A Comparative Analysis Among Hominids and African Apes." Kent State University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=kent1427206046.
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Guirimand, Nicolas. "Entre la réparation des corps mutilés et la correction des imperfections physiques : une chirurgie en quête de légitimité : Analyse sociohistorique de la construction de la chirurgie esthétique en France." Paris, EHESS, 2007. http://www.theses.fr/2007PA030165.
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Pour analyser la construction de la chirurgie esthétique, il faut comprendre ce qu'ont été les conditions de possibilité qui ont permis à cette chirurgie "futile" d'être pratiquée et répondre à la question de ce qui a rendu acceptable socialement des opérations sur des corps sains. Notre travail a dû élargir son objet à l'analyse sociohistorique de construction de la spécialité faisant fonction de matrice à la chirurgie esthétique, la chirurgie plastique. Aussi, il nous a fallu travailler sur l'histoire des rapports entre la chirurgie esthétique à sa matrice et sur les luttes de concurrence entre plasticiens et chirurgiens esthétiques dont l'enjeu est la définition de la pratique légitime, partant de ses contours, de son enseignement et de la construction d'un marché de l'esthétique avec ses diverses composantes. Au final, l'objet "futile" devenait un analyseur des transformations de l'espace chirurgical qui permet d'observer les luttes de concurrence entre chirurgiens et médecinsTo analyze the construction of platic surgery, it is necessary to understand what conditions of possibility enabled this "futile" surgery to be practiced and to answer the question of what made operations on healthy bodies socially acceptable. Our work had to widen its object to the sociohistorical analysis of construction of the specialty using the matrix of aesthetic surgery : plastic surgery. Also, it was necessary for us to work on the history of the relation of cosmetic surgery to its matrix and on the fights of competition between plastics surgeons and aesthetics surgeons whose goal is the definition of the legitimate practice, on the basis of its contours, of its teaching and the construction of an esthetics market with its various components. Finally, the "futile" object became an analyzer of the transformations of the surgical space which makes it possible to observe the struggles and competitions between surgeons and doctors
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Barkat, Daoud Saïda. "Savoirs, Représentations & Pratiques d'intervention sur le Sexe altéré des Femmes Noires (France, XVIIe-XXIe siècle). Le dispositif biopolitique de la chirurgie des mutilations sexuelles : technologie de genre, Race, Réparation et Soin." Thesis, Paris, EHESS, 2019. http://www.theses.fr/2019EHES0168.
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L'altération du sexe des femmes africaines et afropéennes a souvent été appréhendée comme relevant d'institutions culturelles, de conventions, ou encore de normes sociales régissant les rapports sociaux de sexe dans les groupes la mettant en œuvre. Privilégiant plutôt une interprétation en termes de technologie – le dispositif de la lame comme ensemble de discours, pratiques et expériences incorporées – cette thèse étudie le dispositif de la "chirurgie des mutilations" à propos duquel elle se pose deux questions. Quel le devenir du sexe altéré à l'épreuve de la lame ? L'articulation des rapports entre sexualité, corps, violence, réparation et technologie de genre est étudiée dans les pratiques médicales de deux protocoles de chirurgie réparatrice. La médecine s'attelle-t-elle à guérir les femmes des mutilations sexuelles ou à soigner la violence infligée par la lame à leur sexe. Quels sont les enjeux attachés au corps, à la sexualité et à la souffrance des femmes excisées dans l'intérêt singulier que suscitent les mutilations sexuelles dans la société française des époques modernes et contemporaines ? L'exploration d'un vaste corpus de sources manuscrites et d'archives a permis de tracer la construction médicale et anthropologique du Corps Noir Altéré à travers les discours de la médecine au XVIème siècle, des récits de voyage au XVIIème siècle, puis de l'anthropologie raciale du XIXème siècleThe alteration of African and Afropean women genitals has often been seen as a matter of cultural institutions, conventions, or social norms governing gender relations in the groups implementing it. Rather, favouring an interpretation in terms of technology - the device of the blade as a set of embedded discourses, practices and experiences - this thesis studies the device of "mutilation surgery" about which it raises two questions. What is the becoming of the altered sex under the blade proof? The articulation of relationships between sexuality, body, violence, violence, reparation and gender technology is studied in the medical practices of two reconstructive surgery protocols. Is medicine working to heal women from female genital mutilation or to heal gender violence inflicted by the blade? What are the issues related to the body, sexuality and suffering of excised women in the singular interest that sexual mutilation arouses in French society in modern and contemporary times? The exploration of a vast corpus of manuscript sources and archives has made it possible to trace the medical and anthropological construction of the Altered Black Body through the discourses of medicine in the 16th century, travel accounts in the 17th century, and racial anthropology in the 19th century
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Baveye, Laurie. "Exercer la médecine en milieu princier au XVème siècle : l'exemple de la cour de Bourgogne, 1363-1482." Thesis, Lille 3, 2015. http://www.theses.fr/2015LIL30004/document.
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L'objet de la présente étude est de déterminer quelle place était accordée à la pratique de la médecine et aux professionnels de santé dans les cours princières occidentales du bas Moyen Age, à travers l'exemple de la cour des ducs de Bourgogne Valois, de l'avènement de Philippe Hardi en 1363 à la mort de Marie de Bourgogne en 1482. Dans une première partie sont identifiées les différentes professions médicales représentées à la cour de Bourgogne : physiciens ou médecins, chirurgiens, barbiers, épiciers-apothicaires et sages-femme, ainsi que leurs différentes voies d'accès à la cour ducale. Ces spécialistes se distinguent par la formation qu'ils ont reçue et par leurs compétences particulières qui, réunies, leurs permettent de former une équipe soignante polyvalente. L"organisation de celle-ci au sein de l'hôtel ducal et ses limites seront abordées dans une deuxième partie. Ce personnel médical, gravitant au plus près de la famille ducale, bénéficie de revenus et privilèges notables, afférents à la place qui leur est attribuée à la cour. La troisième partie de cette thèse est consacrée à la pratique médicale proprement dite : les différentes étapes de la prise en charge du patient, nommée "collatio", sont détaillées. Elles visent à établir le diagnostic. Les divers procédés permettant de rétablir l'équilibre humoral sont ensuite décrits : ils prennent la forme, en préventif, de conseils d'hygiène de vie ; en curatif, de traitements physiques et psychologiques, médicamenteux et chirurgicaux. Le rôle fondamental de praticiens de santé au moment des naissances et décès princiers constituent les dernières analyses de ces travaux; Fondés sur un dépouillement de sources comptables essentiellement, mais aussi normatives, didactiques et narratives, ils sont accompagnés d'un catalogue prosopographique reprenant la biographique de chacun des praticiens ayant fréquenté la cour de Bourgogne au cours de la période considéréeThe purpose of this study is to determine what place was given to the practice of medicine ans health professionals in Western princely courts of the late Middle Ages, through the example of the court of dukes of Burgundy Valois, from the accession of Philip the Bold in 1363 to the death of Mary Burgundy in 1482. In the first part are identified the various medical professions represented at the court of Burgundy : physicians, surgeons, barbers, apothecaries ans midwives, and their different access to the ducal court. These spécialists are distinguished by their training and their special sdills which, combined allows them to form e versatile healthcare team. The organization of the latter in the "hôtel", and limitations, will be addressed in the second part. This gravitating medical personnel closer to the ducal family gains income and notable privileges relating to the place assigned to them in court. The third part of this dissetation is devoted to the actual medical practice : the different stages of the parient's care are detailed, namely the collective consultation, to estavlish the diagnosis. The various methods to restore humoral balance are then desceibed : lifestyle advices for the prenventive aspect ; and physical, psychological, medical and surgical treatments for the curative one. The fundamental role of health practitoners at the time of princely births and deaths constitute the latest analysis of this work. Based mainly on accounting sources, but also normative, didactic and narrative, they are accompanied by a prosopographic catalog gathering the biography of each practitioner who attended the court of Burfundy during the period
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Hsieh, Pei-chun, and 謝佩君. "The psychology of rehabilitation after major surgery and history of the competition in elite athletes." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/43168009647757584841.
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碩士國立臺灣師範大學
運動競技學系
103
Abstract This study aimed to explore the elite athletes in rehabilitation psychology process after major surgery, as well as the important factors affecting the transition of athletes return to the court less than two years. The qualitative study was conducted by in-depth interviews, to interview the five respondents of women's team sports players who represented to participate international competition at least the Asia-class competition. Interview results are supplemented by literature review, collation and analysis via the concept of narrative analysis. The findings of this study showed the main situation and the factors of elite players injured, rehabilitation psychology process after major surgery and return to the court are as follows: 1) The main reasons that cause most outstanding athletes injured are compitition, fatigue, overtraining, and climate, 2) after the injured, the psychological and emotion of alathlete in compliance with the stage model and the cognitive model, gradually overcome the shadow and inner fear, transition from depression and other negative emotions to positive by self-talk goals setting to rediscover their own values, 3) the important factors in rehabilitation psychology process after major surgery than return to court successfully can be found in family, friends, teammates, coaches and trainer support, plus the players self-talk, can enhance mental construction, giving players a positive energy and reduce negative thoughts. The follow-up studies could be compare with personal projects and group projects, individual sports and team sports contain different gender, in order to find the variety factors cause to hurt, and the differences in the process of rehabilitation to do in-depth analysis.
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David, David John 1940. "The Australian Craniofacial Unit, 1975-1996 / David John David." 1997. http://hdl.handle.net/2440/38285.
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Includes bibliographical references.2 v. :
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Sets out the principles of craniofacial surgery and how they have been utilised to form the Australian Craniofacial Unit. Progress of the organisation is mapped over twenty one years using selected published papers in which the author has in some way contributed to the development of teaching, research and service in craniofacial surgery. Papers are grouped so as to show the progress made in the areas of trauma, the craniosynostoses, rare craniofacial clefts, frontal ethmoidal meningoencephaloceles, craniofacial tumours, as well as research and development.
Thesis (M.D.)--University of Adelaide, Dept. of Surgery, 1999
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David, David John 1940. "The Australian Craniofacial Unit, 1975-1996." Thesis, 1997. http://hdl.handle.net/2440/38285.
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Sets out the principles of craniofacial surgery and how they have been utilised to form the Australian Craniofacial Unit. Progress of the organisation is mapped over twenty one years using selected published papers in which the author has in some way contributed to the development of teaching, research and service in craniofacial surgery. Papers are grouped so as to show the progress made in the areas of trauma, the craniosynostoses, rare craniofacial clefts, frontal ethmoidal meningoencephaloceles, craniofacial tumours, as well as research and development.Thesis (M.D.) -- University of Adelaide, Dept. of Surgery, 1999
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"Soul-sick stomachs, distempered bodies, and divine physicians: Morality and the growth of the English medical profession." Tulane University, 2008.
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Historians studying healing in the seventeenth century have concluded that there was no formalized medical profession in that century 1, yet by the end of the eighteenth century, a new standard caregiver of the sick had taken hold: the university-educated physician.2 This new breed was more educated, respected, and autonomous than healers of past centuries. Although the rise of the profession of medicine and the medical man has been well documented, historians have not explained why people increasingly enlisted the services of licensed practitioners. This dissertation will examine one crucial but under-analyzed aspect of illness and its treatment: the moral dimension, to argue that religious attitudes and beliefs played a vital role in society's conception of illness and the options available to alleviate suffering In early modern England, bodily health and the health of one's soul were inexorably entwined. It was therefore imperative that physicians be seen as capable of caring for both in order to be trusted with the whole health of the individual. Their ability to embrace the nexus of physical and spiritual health is what began to set the learned physician apart from all other types of healers over the course of the seventeenth century. They were able to combine the legacy of their university training with an emerging sense that their skills were ordained by God to cure disease, particularly those considered punishment for sin, in order to present themselves as protectors of a bodily health that was dependent on both physical and spiritual wellness In a society in which disease was largely interpreted in terms of moral agency, and the physical and spiritual world were so intimately connected, the responsibility of caring for the entire patient, both body and soul, was a matter of public trust. To assume such trust required the highest degree of moral authority, a trait which physicians argued was connected to being learned. Their ability to convince the public of their moral authority is what ultimately proved to be their most powerful weapon against lay and popular healers at a time when there were so many other viable options for health care 1Margaret Pelling, The Common Lot: Sickness, Medical Occupations and the Urban Poor in Early Modern England (New York: Longman, 1998), 244. Similar notions have been expressed by Roy Porter and Dorothy Porter, In Sickness and in Health: The British Experience 1650-1850 (London: Fourth Estate, 1988) and Lucinda Beier, 'In Sickness and in Health: A Seventeenth Century Family's Experience,' in Patients and Practitioners: Lay Perceptions of Medicine in Pre-Industrial Society, ed. Roy Porter (Cambridge: Cambridge University Press, 1985), 4-5. 2The group of medical men upon which this dissertation focuses are those who were considered in the seventeenth century to be 'learned physicians,' meaning they had earned university degrees in medicine, either in England or on the Continent. Such individuals were a fairly new group in England, the product of what Harold Cook has termed the intellectual and educational changes of the late fifteenth and sixteenth centuries. They are not necessarily fellows, licentiates, or even extra-licentiates of the College of Physicians, as this would restrict the group to a scant number. They are, moreover, individuals who considered themselves to be medical professionals, rather than those who merely dabbled in or 'topped off' their salaries through medicineacase@tulane.edu
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Miranda, Ana Luísa Moreira. "Piezocirurgia no consultório de Medicina Dentária." Master's thesis, 2016. http://hdl.handle.net/10284/5774.
Full textAbstract:
A presente Tese de Mestrado em Medicina Dentária tem como tema a Piezocirurgia e, sobre ela, pretende-se saber a sua aplicabilidade no consultório do Médico Dentista, nomeadamente na área da Cirurgia oral.
A pesquisa bibliográfica foi realizada através de bases de dados, como a Medline, Science Direct e a Pub-Med, entre outras. Limitou-se a pesquisa, temporalmente, entre 2000 e 2016, e nas línguas Portuguesa e Inglesa. Excluiu-se todas as referências a estudos animais e, todas as que, em nada, contribuiríam para o conteúdo especificado.
A cirurgia Piezoeléctrica é uma técnica de osteotomia atraumática, quando comparada a técnicas convencionais, e que revoluciona a área da Cirurgia Oral, através do seu corte preciso e altamente selectivo, mas também através do fenómeno de cavitação que a caracteriza, e que garante um campo operatório livre, uma óptima visibilidade, e, consequentemente, uma maior segurança do operador, culminando tudo isto no sucesso do tratamento. A sua maior desvantagem é o tempo de trabalho que requere, contudo este tende a diminuir, e a ser ainda menor que o tempo de trabalho exigido na cirurgia convencional.
Inúmeras são as aplicações da Piezocirurgia, mas na área da Medicina Dentária, nomeadamente na Cirurgia Oral, destaca-se o levantamento do seio maxilar, o aumento da crista óssea, a extracção dos terceiros molares impactados e a cirurgia ortognática.The Master’s Thesis on Dentistry presented has, as theme, Piezosurgery and, about it, we intend to known it’s applicability, specifically in the Oral Surgery area. The bibliographic research was made through data bases as Medline, ScienceDirect, Pub-Med, among others. The research was temporally limited between 2000 and 2016, and linguistically by the Portuguese and English idioms. All the references to animal studies and those that, in nothing would contribute to the specified content, were excluded. The Piezoelectric Surgery is an atraumatic and revolutionary osteotomic technique, when compared to conventional surgery, due to its precise and extremely selective cut, and also due to its cavitation phenomenon, which guarantees a free operative camp, a great visibility and, consequently, a bigger safety of the clinic and, therefore an increased success of the intervention. Its biggest disadvantage is the longest surgical time, even though this tends to decrease as the surgeon gains experience. Surgical time in the piezo will probably become shorter than the one needed in conventional surgery. There are innumerous aplications of the Piezosurgery, but in Dentistry, in Oral surgery specially, it stands out the sinus lift, the ridge expansion, the extraction of impacted third molars, and the orthognathic surgery.
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STUCHLÍKOVÁ, Jindřiška. "Předoperační příprava v kontextu historického vývoje." Master's thesis, 2019. http://www.nusl.cz/ntk/nusl-395686.
Full textAbstract:
The thesis "Preoperative Preparation in the Context of Historical Development" is a theoretical dissertation that deals with the history of not only the preoperative preparation but also with nursing and surgery dividing them into several time horizons. The preoperative preparation is an inseparable part of any surgery and based on it the nursing specifications are determined. This thesis is written as a detailed search of primary and secondary sources. The thesis is divided into four main chapters that deal with the history of the preoperative preparation in connection with nursing, nurse education and the preoperative preparation today. The preoperative preparation has undergone many changes during its development. It was influenced by the factors occurring at that time. Nurses had to adapt to the time to be able to respond to changes and to learn in terms of surgery. The aim of the thesis was to analyse the development of the preoperative preparation and point out the influence of the nursing care on the preoperative preparation from a historical perspective. Two research questions were chosen at the outset in connection with the objective: How did the preoperative preparation develop? How has the preoperative preparation changed over time? On the basis of a textual analysis, it emerged the greatest development occurred in the 19th century because that is the time when the preoperative preparation got its name. This dissertation describes it is written using an analytical method, and consequently it is elaborated as an interpretive text.
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Doody, Rachelle Smith. "Aphasia: Some neurological, anthropological and postmodern implications of disturbed speech." Thesis, 1992. http://hdl.handle.net/1911/16508.
Full textAbstract:
This work begins by examining the history of aphasia studies, placing them in the context of historically concurrent theories about speech and language. The historical analysis can be read as a deconstructive incision into contemporary discourses which use information about language to make inferences about brain functioning or thought processes. A deconstructive critique of aphasiology and those sciences upon which it is built, including linguistics and localization theory, suggests that aphasia is constructed artificially so that it cannot be localized or explained by brain mechanisms.
Anthropological influences in this work inform the style of analysis as well as the range of inquiry. Situated in postmodern anthropology, the thesis includes an investigation of positioning: positioning of the author within medicine (neurology) and anthropology; and positioning as a phenomenon brought about by certain sets of practices. Among these practices are those related to the scientific method and those related to more interpretive or hermeneutic strategies. Several controversies within anthropology are related to the clash between science and not-science, including feminist and postmodern debates. Practices, which are situation-dependent, are not as conflicted as theories are and provide reasonable ways to separate sense (or meaningfulness) from non-sense (or artifacts) in daily life and work.
Related to questions of method and interpretation are questions about "data." What count(s) as data? Should units of significance be predetermined, or discovered in the process of investigation? How do standardized methodologies or interpretive expectations shape the outcome of clinical, scientific, and anthropological studies? A narrative style is employed to discuss these questions by telling particular stories involving research and publication: case reports in neurology; semantics of sentence accent in Alzheimer's disease; and fieldwork in northern Thailand concerning nonliteracy and its effects on cognitive processes among Karen hilltribes. These disciplinary projects are contrasted and data creation discussed.
What began as an examination of the history of aphasia studies concludes in discussion of aphasic speech as an example/critique of postmodern and anthropological discourse. Practices that cluster around the study of aphasia, particularly those involving living patients, provide useful critiques to scientific, anthropological and postmodern theorizations.
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Moisão, Maria Cristina Piloto. "A arte das mãos - cirurgia e cirurgiões em Portugal durante os séculos XII a XV." Master's thesis, 2017. http://hdl.handle.net/10362/32884.
Full textAbstract:
Este trabalho constitui um estudo sobre os cirurgiões medievais portugueses como um grupo social e como profissionais, num período compreendido entre o início da nacionalidade e o final do século XV. Avaliam-se as doenças e traumatismos relacionados com a prática da cirurgia, a legislação vigente, a inclusão na sociedade circundante, as relações familiares, a prática de actos profissionais, a distribuição geográfica pelo território nacional, o grupo socio-religioso em que estavam incluídos e a instrução que detinham. Como actividade complementar, procede-se à publicação de algumas leis e apresentam-se fichas prosopográficas dos cirurgiões estudados.
Conclui-se que a legislação portuguesa foi precoce, abrangente quanto a credo e género, simultânea e semelhante com a dos físicos; a prática da cirurgia estava sujeita a juramento ético e a autorização régia; o número de cirurgiões aumentou durante toda a Idade Média portuguesa; existiu uma ligação profíqua com a corte e a aristocracia, mas não com o clero; muitos dos profissionais foram em simultâneo médicos e a inclusão profissional com o grupo dos barbeiros foi raríssima; possuíam residência estável, preferencialmente em meio urbano; detiveram relações familiares algo frequentes com indivíduos da mesma profissão; cerca de metade eram judeus; e muitos pertenceram ao grupo dos letrados.This work’s aim is the study of the Portuguese medieval surgeons as a social group and as professionals, in a period between the beginning of nationality and the end of the fifteenth century. It appraises diseases and injuries related to the practice of surgery, the legislation connected with surgeons, their inclusion in the surrounding society, family relations, the practice of professional acts, the geographic distribution throughout the national territory, the socio-religious group in which they were included and the instruction they had. As a complementary activity, some laws are published and prosopographic files of the studied surgeons are presented. It is concluded that the Portuguese legislation was precocious, comprised people of different faith and gender, simultaneous and similar to the physician's; the practice of surgery was subject to ethical oath and royal authorization; the number of surgeons increased throughout the Portuguese Middle Ages; there was a proficuous connection with the court and the aristocracy, but not with the clergy; many of the professionals were simultaneously physicians and the professional inclusion with the group of barbers was very rare; they had a stable residence, preferably in urban areas; they had very frequent family relations with individuals of the same profession; about half were Jews; and many belonged to the group of the literate men.
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Giri, Nitai Charan. "Structural investigations of early intermediates and nickel inhibition complexes of human DNA and histone demethylases." 2013. https://scholarworks.umass.edu/dissertations/AAI3589025.
Full textAbstract:
The toxicity of nickel compounds is most clearly demonstrated in nickel refinery workers. Nickel exposure leads to lung and nasal cancers and increased risk of acute respiratory syndromes. The toxicity of nickel compounds has been attributed to its roles in oxidative damage, changes in gene expression by an epigenetic mechanism, and inhibition of iron containing enzymes. For this reason, we are interested in the mechanisms of nickel induced inhibition of some of these enzymes. Non-heme iron enzymes carry out a broad number of essential biological reactions in mammalian metabolism, including several that are involved DNA repair and histone demethylation, and thus are involved in gene expression by an epigenetic mechanism. The enzymes involved in DNA repair (e.g., ABH2) and histone demethylation ( e.g., JMJD2 proteins) require Fe(II) and αKG for their function. The replacement of Fe(II) in the active site by other metal ions, including Ni(II), produces an inactive enzyme. Cellular DNA undergoes alkylation damage by chemicals that modify DNA bases and this damage can be inherited. Cells have evolved systems to repair this DNA alkylation damage. In human, ABH2 repairs endogenously formed 1-methyladenine (1-MeA) and 3-methylcytosine (3-MeC). Our experiment suggests that nickel inhibits ABH2 in a dose dependent manner. The inactivation of ABH2 will lead to increased DNA methylation and subsequent transcriptional silencing, which can result in caner and other developmental defects. Histone tails undergo a number of posttranslational modification including acetylation, methylation, phosphorylation and ubiquitination. Differential methylation of histone H3 and H4 lysyl residues regulates processes including heterochromatin formation, X-chromosome inactivation, DNA repair and transcriptional regulation. The increase in cellular nickel concentration leads to an increase in the global levels of H3K9Me1 and H3K9Me2 – not by affecting histone methyltransferases, but by inhibiting a group of Fe(II) and αKG dependent histone demethylases. Using JMJD2A and JMJD2C as examples, we show that JMJD2 family of histone demethylases is also highly sensitive to inhibition by Ni(II) ions. Isothermal titration calorimetry (ITC) has been used to understand the binding of Fe(II) and Ni(II) to ABH2. Our ITC results indicate that both Fe(II) and Ni(II) form 1:1 complexes with ABH2, but Ni(II) binds ABH2 stronger than Fe(II). X-ray absorption spectroscopy (XAS) has been used as a structural probe of the active site metal center in WT-recombinant ABH2, truncated JMJD2 proteins (1 – 350 aa) and Ni(II)-substituted WT-recombinant ABH2 and JMD2 proteins in the presence and/or absence of αKG and substrate in order to examine the reaction mechanism and ascertain the intermediate(s) affected by nickel substitution. Our XAS results indicate that in the presence of both αKG and substrate the iron site is five coordinate while the nickel site is six coordinate and thus, nickel site does not have any empty coordination site for oxygen binding and activation. Thus, using ABH2 and JMJD2 proteins as examples, we show that Fe(II) and αKG dependent enzymes are inhibited by Ni(II) ions. This is consistent with previous reports in literature on other Fe(II) and αKG dependent enzymes. Our results indicate that Ni(II) inhibits ABH2 and JMJD2 proteins by replacing the active site metal and both electronic and steric components are involved. Inhibition of some of these non-heme iron enzymes, like histone demethylases may be one way nickel can alter gene expression by an epigenetic mechanism.