Humanized mouse

A humanized mouse is a mouse carrying functioning human genes, cells, tissues, and/or organs. Humanized mice are commonly used as small animal models in biological and medical research for human therapeutics.
A humanized mouse or a humanized mouse model is one that has been xenotransplanted with human cells and/or engineered to express human gene products, so as to be utilized for gaining relevant insights in the " in vivo" context for understanding of human-specific physiology and pathologies. A lot of our knowledge about several human biological processes has been obtained from studying animal models like rodents and non-human primates. In particular, small animals such as mice are advantageous in such studies owing to their small size, brief reproductive cycle, easy handling and due to the genomic and physiological similarities with humans; moreover, these animals can also be genetically modified easily. Nevertheless, there are several incongruencies of these animal systems with those of the humans, especially with regard to the components of the immune system. To overcome these limitations and to realize the full potential of animal models to enable researchers to get a clear picture of the nature and pathogenesis of immune responses mounted against human-specific pathogens, humanized mouse models have been developed. Such mouse models have also become an integral aspect of preclinical biomedical research.
History.
The discovery of the athymic mouse, commonly known as the nude mouse, and that of the SCID mouse were major events that paved the way for humanized mice models. The first such mouse model was derived by backcrossing C57BL/Ka and BALB/c mice, featuring a loss of function mutation in the "PRKDC" gene. The "PRKDC" gene product is necessary for resolving breaks in DNA strands during the development of T cells and B cells. Dysfunctional "PRKDC" gene leads to impaired development of T and B lymphocytes which gives rise to severe combined immunodeficiency (SCID). In spite of the efforts in developing this mouse model, poor engraftment of human hematopoietic stem cells (HSCs) was a major limitation that called for further advancement in the development humanized mouse models. The next big step in the development of humanized mice models came with transfer of the "scid" mutation to a non-obese diabetic mouse. This resulted in the creation of the NOD-"scid" mice which lacked T cells, B cells, and NK cells. This mouse model permitted for a slightly higher level of human cell reconstitution. Nevertheless, a major breakthrough in this field came with the introduction of the mutant interleukin 2 receptor α ("IL2rα") gene in the NOD-"scid" model. This accounted for the creation of the NOD-"scid"-γcnull mice (NSG or NOG) models which were portrayed to have defective interleukins IL-2, IL-4, IL-7, IL-9, and IL-15. Researchers evolved this NSG model by knocking out the RAG1 and RAG2 genes (recombination activation genes), resulting into the RAGnull version of the NSG model that was devoid of major cells of the immune system including the natural killer cells, B lymphocytes and T lymphocytes, macrophages and dendritic cells, causing the greatest immunodeficiency in mice models so far. The limitation with this model was that it lacked the human leukocyte antigen. In accordance to this limitation, the  human T cells when engrafted in the mice, failed to recognize human antigen-presenting cells, which consequated in defective immunoglobulin class switching and improper organization of the  secondary lymphoid tissue.
To circumvent this limitation, the next development came with the introduction of transgenes encoding for HLA I and HLA II in the NSG RAGnull model that enabled buildout of human T-lymphocyte repertoires as well as the respective immune responses.
Types.
Engrafting an immunodeficient mouse with functional human cells can be achieved by intravenous injections of human cells and tissue into the mouse. This section highlights the various humanized mice models developed using the different methods.
Hu-PBL-"scid" model.
This model is developed by intravenously injecting human PBMCs into immunodeficient mice. The peripheral blood mononuclear cells to be engrafted into the model are obtained from consented adult donors. The advantages associated with this method are that it is comparatively an easy technique, the model takes relatively less time to get established and that the model exhibits  functional memory T cells. It is particularly very effective for modelling graft vs. host disease. The model lacks engraftment of B lymphocytes and myeloid cells. Other limitations with this model are that it is suitable for use only in short-term experiments (<3 months) and the possibility that the model itself might develop graft vs. host disease.
Hu-SRC-"scid" model.
Hu-SRC-"scid" mice are developed by engrafting CD34+ human hematopoietic stem cells into immunodeficient mice. The cells are obtained from human fetal liver, bone marrow or from blood derived from the umbilical cord, and engrafted via intravenous injection. The advantages of this model are that it offers multilineage development of hematopoietic cells, generation of a naïve immune system, and if engraftment is carried out by intrahepatic injection of newborn mice within 72 hours of birth, it can lead to enhanced human cell reconstitution. Nevertheless, limitations associated with the model are that it takes a minimum of 10 weeks for cell differentiation to occur, it harbors low levels of human RBCs, polymorphonuclear leukocytes, and megakaryocytes.
BLT (bone marrow/liver/thymus) model.
The BLT model is constituted with human HSCs, bone marrow, liver, and thymus. The engraftment is carried out by implantation of liver and thymus under the kidney capsule and by transplantation of HSCs obtained from fetal liver. The BLT model has a complete and totally functional human immune system with HLA-restricted T lymphocytes. The model also comprises a mucosal system that is similar to that of humans. Moreover, among all models the BLT model has the highest level of human cell reconstitution.
However, since it requires surgical implantation, this model is the most difficult and time-consuming to develop. Other drawbacks associated with the model are that it portrays weak immune responses to xenobiotics, sub-optimal class switching and may develop GvHD.
Established models for human diseases.
Several mechanisms underlying human maladies are not fully understood. Utilization of humanized mice models in this context allows researchers to determine and unravel important factors that bring about the development of several human diseases and disorders falling under the categories of  infectious disease, cancer, autoimmunity, and GvHD.
Infectious diseases.
Among the human-specific infectious pathogens studied on humanized mice models, the human immunodeficiency virus has been successfully studied. Besides this, humanized models for studying Ebola virus, Hepatitis B, Hepatitis C, Kaposi's sarcoma-associated herpesvirus, Leishmania major, malaria, and tuberculosis have been reported by various studies.
NOD/"scid" mice models for dengue virus and varicella-zoster virus, and a Rag2null𝛾cnull model for studying influenza virus have also been developed.
Cancers.
On the basis of the type of human cells/tissues that have been used for engraftment, humanized mouse models for cancer can be classified as patient-derived xenografts or cell line-derived xenografts. PDX models are considered to retain the parental malignancy characteristics at a greater extent and hence these are regarded as the more powerful tool for evaluating the effect of anticancer drugs in pre-clinical studies. Humanized mouse models for studying cancers of various organs have been designed. A mouse model for  the study of breast cancer has been generated by the intrahepatic engraftment of SK-BR-3 cells in NSG mice. Similarly, NSG mice intravenously engrafted with patient-derived AML cells, and those engrafted (via subcutaneous, intravenous or intra-pancreatic injections) with patient-derived pancreatic cancer tumors have also been developed for the study of leukemia and pancreatic cancer respectively. Several other humanized rodent models for the study of cancer and cancer immunotherapy have also been reported.
Autoimmune diseases.
Problems posed by the differences in the human and rodent immune systems have been overcome using a few strategies, so as to enable researchers to study autoimmune disorders using humanized models.  NSG mice engrafted with PBMCs and administered with myelin antigens in Freund's adjuvant, and antigen-pulsed autologous dendritic cells have been used to study multiple sclerosis. Similarly, NSG mice engrafted with hematopoietic stem cells and administered with pristane have been used for studying lupus erythematosus. Furthermore, NOG mice engrafted with PBMCs has been used to study mechanisms of allografts rejection in vivo.


Workhouse Infirmary Nursing Association

The Workhouse Infirmary Nursing Association was created in 1879 to organise training and act as an employment agency for nurses in Poor law infirmaries and workhouses.
It later became the Workhouse Nursing Association. Princess Christian was the president.
It vetted applicants and in one year only 18 of 41 trained nurses who applied were considered suitable.
Louisa Twining and Florence Nightingale were involved with its formation.


Leo Eloesser

Leo Eloesser (July 29, 1881 – October 4, 1976), a noted thoracic surgeon, was born in San Francisco. He spent his undergraduate years at Berkeley and in 1901 went to Germany to study medicine. He became a pioneer in the field of thoracic surgery and joined the faculty of the Stanford Medical School in 1912. A surgical procedure known as the Eloesser flap is named for him.
Known for his work among the poor and indigent, Dr. Eloesser served as the physician for Tom Mooney, whose trial and imprisonment on charges stemming from a 1916 bombing made him a cause célèbre of the American Left. He met Diego Rivera in 1926 and became Frida Kahlo's lifelong friend and medical adviser. In the Spanish Civil War he saw service at Teruel and on the Ebro front with his own Mobile Surgical Hospital.
At the end of World War II he was in China with the Eighth Route Army under the auspices of UNICEF.
Eloesser wrote a manual for use in Chinese midwifery training courses, "Pregnancy, Childbirth and the Newborn: A Manual for Rural Midwives" which was published in Spanish, English, and Portuguese. In the 1960s, it influenced Ina May Gaskin, author of "Spiritual Midwifery" (1977), and others in the U.S. midwifery movement.
Eloesser spent the last 25 years of his life in Mexico with his companion, Joyce Campbell.


Edmund B. Delabarre

Edmund Burke Delabarre (1863 – 1945), was a researcher and professor of psychology at Brown University. He graduated from Amherst College in 1886. He was a pioneer in the field of shape perception and on the interaction between mental processes and the involuntary movements of the body.
He became famous, particularly in Portugal, because of his interpretation of the inscriptions present on the surface of Dighton Rock, a boulder on the shore of the Taunton River, in southeastern Massachusetts. He attributed the carvings to Miguel Corte-Real, a Portuguese navigator who left Lisbon in May 1502 on an exploration trip to the western Atlantic, never to return. Delabarre claimed that the stone bears carvings of the coat of arms of Portugal, the name of Miguel Corte-Real, and the date 1511.
In 1899, Delabarre was instrumental in formation of the "University Club" in Providence


Medicare Rights Center

The Medicare Rights Center is a nonprofit organization founded in June 1989 as the Medicare Beneficiaries Defense Fund (MBDF) by Diane Archer. The organization's self-declared mission is to "ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs, and public policy initiatives."
One of the first actions of the MBDF was to bring a 1989 lawsuit brought against the federal government on the grounds that the Medicare Explanation of Benefits (EOB) failed to mention limits on what a doctor may charge for a service or what a beneficiary must pay.
That same year, Archer set up a "national consumer helpline" in order to provide counseling to Medicare recipients. The helpline then publishes an 'annual trends report' summarizing the content of these calls made to the Center.
The Medicare Rights Center also maintains an online reference and coursework tool called Medicare Interactive (MI).


Molecular virology

Molecular virology is the study of viruses on a molecular level. Viruses are submicroscopic parasites that replicate inside host cells. They are able to successfully infect and parasitize all kinds of life forms- from microorganisms to plants and animals- and as a result viruses have more biological diversity than the rest of the bacterial, plant, and animal kingdoms combined. Studying this diversity is the key to a better understanding of how viruses interact with their hosts, replicate inside them, and cause diseases.
Viral replication.
Viruses rely on their host to replicate and multiply. This is because viruses are unable to go through cell division, as they are acellular–meaning they lack the genetic information that encode the necessary tools for protein synthesis or generation of metabolic energy; hence they rely on their host to replicate and multiply. Using the host cell's machinery the virus generates copies of its genome and produces new viruses for the survival of its kind and the infection of new hosts. The viral replication process varies depending on the virus's genome.
Classification.
In 1971 David Baltimore, a Nobel Prize-winning biologist, created a system called Baltimore Classification System.According to this system, viruses are classified into seven classes based on their replication strategy:
Replication cycle.
Regardless of the differences among viral species, they all share six basic replication stages:
Attachment is the cycle's starting point and consists of specific bindings between anti-receptors (or virus-attachment proteins) and cellular receptors molecules such as (glyco)proteins. The host range of a virus is determined by the specificity of the binding. The attachment causes the viral protein to change its configuration and thus fuse with the host's cell membrane; thereby enabling the virus to enter the cell.
Penetration of virus happens either through membrane fusion or receptor-mediated endocytosis and leads to viral entry. Due to their rigid cellulose-made
(chitin in case of fungal cells) cell walls, plants and fungal cells get infected differently than animal cells. Often, a cell wall trauma is required for the virus to enter the cell.
Uncoating is the removal of viral capsid, which makes the viral nucleic acids available for transcription. The capsid could have been degraded by either host or viral enzymes, releasing the viral genome into the cell.
Replication is the multiplication of virus's genetic material. The process includes the transcription of mRNA, synthesis, and assembly of viral proteins and is regulated by protein expression.
Assembly process involves putting together and modifying newly made viral nucleic acids and structural proteins to form the virus's nucleocapsid.
Release of viruses could be done by two different mechanisms depending on the type of virus. Lytic viruses burst the cell's membrane or wall through a process called lysis in order to release themselves. On the other hand, enveloped viruses become released by a process called budding in which a virus obtain its lipid membrane as it buds out of the cell through membrane or intracellular vesicle. Both lysis and budding processes are highly damaging to the cell, with the exception of retroviruses, and often result in the cell's death.
Viral pathogenesis.
Pathogenicity is the ability of one organism to cause disease in another. There is a specialized field of study in virology called viral pathogenesis in which it studies how viruses infect their hosts at the molecular and cellular level.
In order for the viral disease to develop several steps need to be taken. First, the virus has to enter the body and implant itself into a tissue ( e.g. respiratory tissue). Second, the virus has to reproduce extracellular after invading in order to make ample copies of itself. Third, the synthesized viruses must spread throughout the body via circulatory systems or nerve cells.
With regards to viral diseases it is essential to look at two aspects: (a) the direct effect of virus replication; (b) the body's responses to infection. The course and severity of all viral infections are determined by the dynamic between the virus and the host. Common symptoms of virus infections are fever, body aches, inflammation, and skin rashes. Most of these symptoms are caused by our immune system's response to infection and are not the direct effect of viral replication.
Cytopathis effects of virus.
Often it is possible to recognize virus-infected cells through a number of common phenotypic changes referred to as cytopathis effects. These changes include:
Viral infections.
There are five different types of viral infections:
Prevention and treatment.
Viral vaccines contain inactivated viruses which have lost their ability to replicate. These vaccines can prevent or lower the intensity of viral illness. Developing vaccines against smallpox, polio, and hepatitis B over the past 50 years has had a significant impact on world health and thus on global population. Nevertheless, there have been ongoing viral outbreaks ( such as the Ebola and Zika viruses) in the past few years affecting millions of people all around the globe. Therefore, more advanced understanding of molecular virology and viruses are needed for the development of new vaccines and the control of ongoing/future viral outbreaks.
An alternative way to treat viral infections would be antiviral drugs in which the drug blocks the virus's replication cycle. The specificity of an antiviral drug is the key to its success. These drugs are toxic to both the virus and the host but in order to minimize their damage they are developed in such a way as to be more toxic to the virus than to the host. The efficiency of an antiviral drug is measured by the chemotherapeutic index, given by:


Hai Phong Medical University

Hai Phong University of Medicine and Pharmacy (, abbr.: "HPMU") is a public university established in September 1979 in Hai Phong, Vietnam.
In 2006, the Minister of Health approved the development strategy of Hai Phong Medical University to be the University of Medicine and Pharmacy in Hai Phong, adding new faculties: the faculty of pharmacy, the faculty of odonto-stomatology, the faculty of public health and the faculty of nursing, the faculty of medical technology.


International Field Archery Association

The International Field Archery Association (IFAA), is an amateur sports association that represents 50,000 field archers in 40 member countries. It founded in 1970.
IFAA promotes competition between international and national associations and formulates the rules governing international competition. It creates programmes that recognise archers for proficiency in all IFAA sanctioned competitions.
IFAA creates standards that differentiate between the amateur status and professional status of archers for competition as conducted by and/or sanctioned by the Association. It promotes the development, instruction, coaching and spreading of expertise.


Alan P. Bell

Alan Paul Bell (January 18, 1932 – May 13, 2002) was an American psychologist who worked at the Kinsey Institute.
Bell was born in Newark, New Jersey on January 18, 1932. He earned an undergraduate degree from University of the South and a master's degree from General Theological Seminary. In 1964 he earned a doctorate from Columbia University. He was the father of violinist Joshua Bell.


Provirus

A provirus is a virus genome that is integrated into the DNA of a host cell. In the case of bacterial viruses (bacteriophages), proviruses are often referred to as prophages. However, it is important to note that proviruses are distinctly different from prophages and these terms should not be used interchangeably. Unlike prophages, proviruses do not excise themselves from the host genome when the host cell is stressed.
This state can be a stage of virus replication, or a state that persists over longer periods of time as either inactive viral infections or an endogenous viral element. In inactive viral infections the virus will not replicate itself except through replication of its host cell. This state can last over many host cell generations.
Endogenous retroviruses are always in the state of a provirus. When a (nonendogenous) retrovirus invades a cell, the RNA of the retrovirus is reverse-transcribed into DNA by reverse transcriptase, then inserted into the host genome by an integrase.
A provirus does not directly make new DNA copies of itself while integrated into a host genome in this way. Instead, it is passively replicated along with the host genome and passed on to the original cell's offspring; all descendants of the infected cell will also bear proviruses in their genomes. This is known as lysogenic viral reproduction. Integration can result in a latent infection or a productive infection. In a productive infection, the provirus is transcribed into messenger RNA which directly produces new virus, which in turn will infect other cells via the lytic cycle. A latent infection results when the provirus is transcriptionally silent rather than active.
A latent infection may become productive in response to changes in the host's environmental conditions or health; the provirus may be activated and begin transcription of its viral genome. This can result in the destruction of its host cell because the cell's protein synthesis machinery is hijacked to produce more viruses.
Proviruses may account for approximately 8% of the human genome in the form of inherited endogenous retroviruses.
A provirus not only refers to a retrovirus but is also used to describe other viruses that can integrate into the host chromosomes, another example being adeno-associated virus.
Not only eukaryotic viruses integrate into the genomes of their hosts; many bacterial and archaeal viruses also employ this strategy of propagation. All families of bacterial viruses with circular (single-stranded or double-stranded) DNA genomes or replicating their genomes through a circular intermediate (e.g., tailed dsDNA viruses) have temperate members.


Julian Tudor-Hart

Alan Julian Macbeth Tudor-Hart (9 March 1927 – 1 July 2018), commonly known as Julian Tudor Hart, was a British doctor who worked as a general practitioner (GP) in Wales for 30 years. He was involved with research and wrote many books and scientific articles.
Early life.
Hart was born in London on 9 March 1927, the son of Dr Alexander Tudor-Hart and Dr Alison Macbeth. He studied medicine at Cambridge University and in London, graduating in 1952.
He is a descendant of American businessman Frederic Tudor and Ephraim Hart, a Bavarian Jew who became a prominent merchant in New York, and was reportedly partners with John Jacob Astor. The name was originally Hirz.
His paternal grandfather, the Canadian artist Percyval Hart, married his Polish-French cousin Éléonora Délia Julie Aimée Hart Kleczkowska, and later changed the family surname to Tudor-Hart. Kleczkowska was the daughter of diplomat Michel Alexandre Cholewa, comte Kleczkowski (Michał Kleczkowski; 1818–1886) and granddaughter of Julie Sobieska, a direct descendant of John III Sobieski, king of Poland in the 17th century.
He was a member of the Sigerist Society from 1947 to 1955.
Hart joined the Communist Party of Great Britain, following his father Alex, and stood unsuccessfully as the CPGB candidate for Aberavon at the 1964, 1966 and 1970 general elections.
Career.
He worked for 30 years as a general practitioner in Glyncorrwg, West Glamorgan, Wales, where one of his partners was Dr Brian Gibbons, later minister for health in Wales. Hart became involved in epidemiological research, with Richard Doll and Archie Cochrane. He was a passionate advocate of the National Health Service and of socialism. He was President of the Socialist Health Association.
He was a Fellow of the Royal College of General Practitioners (RCGP) and the Royal College of Physicians (RCP).
In 2006, he was awarded the inaugural Discovery Prize by the RCGP as "a general practitioner who has captured the imagination of generations of GPs with his groundbreaking research". His practice in Glyncorrwg, Wales, was the first in the UK to be recognised as a research practice, piloting many Medical Research Council studies. He was also the first doctor to routinely measure every patient's blood pressure and as a result was able to reduce premature mortality in high risk patients at his practice by 30%. Graham Watt, Professor of General Practice at the University of Glasgow, nominated Dr Tudor Hart for the award. Professor Watt said: "His ideas and example pervade modern general practice and remain at the cutting edge of thinking and practice concerning health improvement in primary care. His work on hypertension showed how high quality records, teamwork and audit are the keys to health improvement. His life-long commitment to the daily tasks of general practice has always given his work and views a salience and credibility with fellow general practitioners. Julian Tudor Hart has been and will remain an inspiration to health practitioners and the communities they serve."
Hart died on 1 July 2018 at the age of 91 years.
Author.
He wrote many books and scientific articles. His last book, "The Political Economy of Health Care: A Clinical Perspective" explores how the NHS might be reconstituted as a humane service for all (rather than a profitable one for the few) and a civilising influence on society as a whole. The book provides 'a big picture' for students, academics, health professionals and NHS users that Tudor Hart hopes will inspire them to challenge received wisdoms about how the NHS should develop in the 21st century.
Hart lists nine (9) characteristics of the National Health Service in its founding that are distinctive and essential to it.
His other writing includes many articles on the management of high blood pressure and on the organisation of health services. His most influential, The Inverse Care Law, published in the Lancet 1971 asserts: "The availability of good medical care tends to vary inversely with the need for the population served. This inverse care law operates more completely where medical care is most exposed to market forces, and less so where such exposure is reduced."


List of cutaneous conditions associated with internal malignancy

There are many skin conditions that may occur which are associated with cancers, as well as some benign tumors, inside the human body.


Emerging Pathogens Institute

The Emerging Pathogens Institute is an interdisciplinary research institution associated with the University of Florida. The Institute is charged with fusing key disciplines to develop outreach, education, and research capabilities designed to preserve the region's health and economy, and to prevent or contain new and re-emerging diseases.
History.
The idea of this Institute was first created by the University of Florida faculty and researchers. They began designing the framework for the Emerging Pathogens Institute back in 2006. Since then, the university has secured funding from the state of Florida for a facility that is estimated to cost $56 million. The structure will house the institute and numerous top researchers. EPI has several dedicated researchers, but is primarily composed of a consortium of researchers spanning nine colleges at UF: Medicine; Pharmacy; Dentistry; Public Health and Health Professions; Veterinary Medicine; Liberal Arts and Sciences; Engineering; Nursing; and Agricultural and Life Sciences.
In March 2009, the Institute received a substantial grant from the Bill and Melinda Gates Foundation. This was the first time that the University of Florida has ever received direct funding from this foundation, and the grant was provided to help researchers develop tools to fight malaria.
Directors of the Institute.
2007–Present J. Glenn Morris


Diane Shader Smith

Diane Shader Smith is an American writer, publicist, and cystic fibrosis advocate.
Life.
Smith wrote for the ABC-TV series, General Hospital and for KIIS Radio Los Angeles. Smith worked at Rogers and Cowan in Hollywood with clients ranging from the Beverly Hills Hotel to Microsoft, and award-winning film marketing campaigns like The Passion of the Christ.
Diane lives in Los Angeles with her husband, Mark, and her son, Micah. Her daughter, Mallory Smith passed away in November of 2017. Mallory is the author of the book Salt in My Soul: An Unfinished Life.
Advocacy.
“An Evening in Mallory’s Garden” was started in 1995 and has raised more than $5 million dollars
Works.
“Undressing Infidelity: Why More Wives are Unfaithful” is a series interviews with women who have cheated to understand why wives stray more often than men.
Smith edited her daughter’s memoir by request for posthumous publication through Penguin Random House on March 12, 2019. It was subsequently optioned for production before its publication by The Invisible War and The Hunting Ground Oscar-nominated directors Kirby Dick and Amy Ziering.


BMJ (company)

BMJ (branded as BMJ Group until 2013) is a provider of journals, clinical decision support, events and medical education. The company, legally the BMJ Publishing Group Ltd, is a wholly owned subsidiary of the British Medical Association. Established in 1840 with the publication of the Provincial Medical and Surgical Journal (later the first edition of the British Medical Journal), it is now a fully commercial organisation with about 550 staff and offices in several locations around the world.
The company's products and services also extend to offer rights and licensing, targeted advertising and sponsorship opportunities for pharmaceutical and healthcare companies, recruiters, and the general medical community.


Hermann Krukenberg

Hermann Krukenberg (21 June 1863 – 3 October 1935) was a German surgeon who was a native of Calbe, Province of Saxony, Germany. He was the brother of pathologist Friedrich Ernst Krukenberg (1871–1946).
Krukenberg studied medicine at the Universities of Bonn, Strassburg and Heidelberg. Afterwards he was a surgical assistant to Friedrich Trendelenburg (1844–1924) in Bonn, and to Max Schede (1844–1902) at Eppendorf Hospital in Hamburg. In 1892 he became manager of a private clinic in Halle an der Saale, and in 1899 was chief surgeon at the municipal hospital in Liegnitz. During World War I he served as a field surgeon.
In 1917 he developed an operation known today as the "Krukenberg procedure". This procedure involves separation of the ulna and radius bones in order to convert a below-elbow amputation stump into a "sensory forceps" that receives its strength from the pronator teres muscle. Among his written works was a 1913 book on physiognomy titled "Gesichtsausdruck des Menschen".


Osteomyelitis

Osteomyelitis (OM) is an infection of bone. Symptoms may include pain in a specific bone with overlying redness, fever, and weakness. The long bones of the arms and legs are most commonly involved in children, while the feet, spine, and hips are most commonly involved in adults.
The cause is usually a bacterial infection, but rarely can be a fungal infection. It may occur by spread from the blood or from surrounding tissue. Risks for developing osteomyelitis include diabetes, intravenous drug use, prior removal of the spleen, and trauma to the area. Diagnosis is typically suspected based on symptoms. This is then supported by blood tests, medical imaging, or bone biopsy.
Treatment of bacterial osteomyelitis often involves both antimicrobials and surgery. In those with poor blood flow, amputation may be required. Treatment of the relatively rare fungal osteomyelitis as mycetoma infections entails antifungal medications. In contrast to bacterial osteomyelitis, amputation or large bony resections is a more common fate of neglected fungal osteomyelitis namely mycetoma where infections of the foot account for the majority of cases. Treatment outcomes of bacterial osteomyelitis are generally good when the condition has only been present a short time. About 2.4 per 100,000 people are affected a year. The young and old are more commonly affected. Males are more commonly affected than females. The condition was described at least as early as the 300s BC by Hippocrates. Before the availability of antibiotics the risk of death was significant.
Signs and symptoms.
Symptoms may include pain in a specific bone with overlying redness, fever, and weakness. Onset may be sudden or gradual. Enlarged lymph nodes may be present.
In fungal infections like Mycetoma there is usually a history of walking bare footed especially in rural and farming areas. Contrary to the mode of infection in bacterial osteomyelitis which is mostly blood born/hematogenous, the mode of fungal osteomyelitis mycetoma originates from the skin then invades deeper tissues until it reaches the bones.
Cause.
In children, the long bones are usually affected. In adults, the vertebrae and the pelvis are most commonly affected.
Acute osteomyelitis almost invariably occurs in children because of rich blood supply to the growing bones. When adults are affected, it may be because of compromised host resistance due to debilitation, intravenous drug abuse, infectious root-canaled teeth, or other disease or drugs (e.g., immunosuppressive therapy).
Osteomyelitis is a secondary complication in 1–3% of patients with pulmonary tuberculosis. In this case, the bacteria, in general, spread to the bone through the circulatory system, first infecting the synovium (due to its higher oxygen concentration) before spreading to the adjacent bone. In tubercular osteomyelitis, the long bones and vertebrae are the ones that tend to be affected.
"Staphylococcus aureus" is the organism most commonly isolated from all forms of osteomyelitis.
Bloodstream-sourced osteomyelitis is seen most frequently in children, and nearly 90% of cases are caused by "Staphylococcus aureus". In infants, "S. aureus", Group B streptococci (most common) and "Escherichia coli" are commonly isolated; in children from one to 16 years of age, "S. aureus", "Streptococcus pyogenes", and "Haemophilus influenzae" are common. In some subpopulations, including intravenous drug users and splenectomized patients, Gram-negative bacteria, including enteric bacteria, are significant pathogens.
The most common form of the disease in adults is caused by injury exposing the bone to local infection. "Staphylococcus aureus" is the most common organism seen in osteomyelitis, seeded from areas of contiguous infection. But anaerobes and Gram-negative organisms, including "Pseudomonas aeruginosa", "E. coli", and "Serratia marcescens", are also common. Mixed infections are the rule rather than the exception.
Systemic mycotic (fungal) infections may also cause osteomyelitis. The two most common are "Blastomyces dermatitidis" and "Coccidioides immitis".
In osteomyelitis involving the vertebral bodies, about half the cases are due to "S. aureus", and the other half are due to tuberculosis (spread hematogenously from the lungs). Tubercular osteomyelitis of the spine was so common before the initiation of effective antitubercular therapy, it acquired a special name, Pott's disease.
The "Burkholderia cepacia" complex has been implicated in vertebral osteomyelitis in intravenous drug users.
Pathogenesis.
In general, microorganisms may infect bone through one or more of three basic methods
The area usually affected when the infection is contracted through the bloodstream is the metaphysis of the bone. Once the bone is infected, leukocytes enter the infected area, and, in their attempt to engulf the infectious organisms, release enzymes that lyse the bone. Pus spreads into the bone's blood vessels, impairing their flow, and areas of devitalized infected bone, known as "sequestra", form the basis of a chronic infection. Often, the body will try to create new bone around the area of necrosis. The resulting new bone is often called an involucrum. On histologic examination, these areas of necrotic bone are the basis for distinguishing between acute osteomyelitis and chronic osteomyelitis. Osteomyelitis is an infective process that encompasses all of the bone (osseous) components, including the bone marrow. When it is chronic, it can lead to bone sclerosis and deformity.
Chronic osteomyelitis may be due to the presence of intracellular bacteria (inside bone cells). Also, once intracellular, the bacteria are able to escape and invade other bone cells. At this point, the bacteria may be resistant to some antibiotics. These combined facts may explain the chronicity and difficult eradication of this disease, resulting in significant costs and disability, potentially leading to amputation. Intracellular existence of bacteria in osteomyelitis is likely an unrecognized contributing factor to its chronic form.
In infants, the infection can spread to a joint and cause arthritis. In children, large subperiosteal abscesses can form because the periosteum is loosely attached to the surface of the bone.
Because of the particulars of their blood supply, the tibia, femur, humerus, vertebra, the maxilla, and the mandibular bodies are especially susceptible to osteomyelitis. Abscesses of any bone, however, may be precipitated by trauma to the affected area. Many infections are caused by "Staphylococcus aureus", a member of the normal flora found on the skin and mucous membranes. In patients with sickle cell disease, the most common causative agent is "Salmonella", with a relative incidence more than twice that of S. aureus.
Diagnosis.
The diagnosis of osteomyelitis is complex and relies on a combination of clinical suspicion and indirect laboratory markers such as a high white blood cell count and fever, although confirmation of clinical and laboratory suspicion with imaging is usually necessary.
Radiographs and CT are the initial method of diagnosis, but are not sensitive and only moderately specific for the diagnosis. They can show the cortical destruction of advanced osteomyelitis, but can miss nascent or indolent diagnoses.
Confirmation is most often by MRI. The presence of edema, diagnosed as increased signal on T2 sequences, is sensitive, but not specific, as edema can occur in reaction to adjacent cellulitis. Confirmation of bony marrow and cortical destruction by viewing the T1 sequences significantly increases specificity. The administration of intravenous gadolinium-based contrast enhances specificity further. In certain situations, such as severe Charcot arthropathy, diagnosis with MRI is still difficult. Similarly, it is limited in distinguishing bone infarcts from osteomyelitis in sickle cell anemia.
Nuclear medicine scans can be a helpful adjunct to MRI in patients who have metallic hardware that limits or prevents effective magnetic resonance. Generally a triple phase technetium 99 based scan will show increased uptake on all three phases. Gallium scans are 100% sensitive for osteomyelitis but not specific, and may be helpful in patients with metallic prostheses. Combined WBC imaging with marrow studies have 90% accuracy in diagnosing osteomyelitis.
Diagnosis of osteomyelitis is often based on radiologic results showing a lytic center with a ring of sclerosis. Culture of material taken from a bone biopsy is needed to identify the specific pathogen; alternative sampling methods such as needle puncture or surface swabs are easier to perform, but do not produce reliable results.
Factors that may commonly complicate osteomyelitis are fractures of the bone, amyloidosis, endocarditis, or sepsis.
Classification.
The definition of OM is broad, and encompasses a wide variety of conditions. Traditionally, the length of time the infection has been present and whether there is suppuration (pus formation) or sclerosis (increased density of bone) is used to arbitrarily classify OM. Chronic OM is often defined as OM that has been present for more than one month. In reality, there are no distinct subtypes; instead there is a spectrum of pathologic features that reflect balance between the type and severity of the cause of the inflammation, the immune system and local and systemic predisposing factors.
OM can also be typed according to the area of the skeleton in which it is present. For example, osteomyelitis of the jaws is different in several respects from osteomyelitis present in a long bone. Vertebral osteomyelitis is another possible presentation.
Treatment.
Osteomyelitis often requires prolonged antibiotic therapy for weeks or months. A PICC line or central venous catheter can be placed for long-term intravenous medication administration. Some studies of children with acute osteomyelitis report that antibiotic by mouth may be justified due to PICC-related complications. It may require surgical debridement in severe cases, or even amputation. Antibiotics by mouth and by intravenous appear similar.
Due to insufficient evidence it is unclear what the best antibiotic treatment is for osteomyelitis in people with sickle cell disease as of 2019.
Initial first-line antibiotic choice is determined by the patient's history and regional differences in common infective organisms. A treatment lasting 42 days is practiced in a number of facilities. Local and sustained availability of drugs have proven to be more effective in achieving prophylactic and therapeutic outcomes. Open surgery is needed for chronic osteomyelitis, whereby the involucrum is opened and the sequestrum is removed or sometimes saucerization can be done. Hyperbaric oxygen therapy has been shown to be a useful adjunct to the treatment of refractory osteomyelitis.
Before the widespread availability and use of antibiotics, blow fly larvae were sometimes deliberately introduced to the wounds to feed on the infected material, effectively scouring them clean.
There is tentative evidence that bioactive glass may also be useful in long bone infections. Support from randomized controlled trials, however, was not available as of 2015.
History.
The word is from Greek words ὀστέον "osteon", meaning bone, μυελό- "myelo-" meaning marrow, and -ῖτις "-itis" meaning inflammation. In 1875, American artist Thomas Eakins depicted a surgical procedure for osteomyelitis at Jefferson Medical College, in an oil painting titled "The Gross Clinic".
Fossil record.
Evidence for osteomyelitis found in the fossil record is studied by paleopathologists, specialists in ancient disease and injury. It has been reported in fossils of the large carnivorous dinosaur "Allosaurus fragilis". Osteomyelitis has been also associated with the first evidence of parasites in dinosaur bones.


Omphalomesenteric duct cyst

Omphalomesenteric duct cysts (ODC, also known as an omphalomesenteric duct remnant or vitelline cyst) are developmental defects relating to the closure of the omphalomesenteric duct. It usually disintegrates within six weeks of gestation, but remnants of the cyst can sometimes be found along the intestines or umbilicus. Any remnants can be removed via surgical means.


Rappaport Vassiliadis soya peptone broth

Rappaport-Vassiliadis soya peptone broth (RVS broth) is used as an enrichment growth medium for the isolation of "Salmonella" species. It is not recommended for the enrichment of "Salmonella" Typhi or Paratyphi, which is inhibited due to the malachite green in RVS broth. It is an alternative to selenite broth. It is not associated with potential teratogenicity problems seen with the use of selenite broth. It enriches salmonellae because they are better able to survive the high osmotic pressure in the medium and because they can multiply at relatively lower pH and higher temperatures compared with other gut bacteria. RVS broth has a pH around 5.2.
Components.
A liter of RVS broth contains:


HealthMarkets

HealthMarkets, Inc., formerly known as UICI, is headquartered in North Richland Hills, Texas.
History.
HealthMarkets was founded in 1983 by Ronald Jensen under United Insurance Companies, Inc. (UICI)
Through its focus on the then-untapped market of self-employed workers, the company was able to grow earnings by more than double between 1984 and 1985. In 1986, UICI made its first public stock offering.
In October 2004, The MEGA Life & Health Insurance Co, a subsidiary of UICI, acquired HealthMarket Inc, which was a small business insurer. Then, in 2005, a group of private equity investors headed by The Blackstone Group acquired HealthMarkets Inc, moving the company from public to private owned. The MEGA Life & Health Insurance Co. brand was officially renamed to HealthMarkets Inc to convey its new consumer focus.
Between 2008 and 2010, several lawsuits were filed against HealthMarkets, Inc., resulting in the Company paying millions of dollars in settlements. As of 2010, HealthMarkets no longer offers Scheduled Benefit plans and has discontinued marketing individually underwritten plans.
Organization Structure.
Subsidiaries of HealthMarkets, Inc. include the following entities:
The Chesapeake Life Insurance Company is an underwriting company for both insurance and non-insurance products marketed under the SureBridge brand name.
HealthMarkets Insurance Agency, Inc., formerly known as Insphere Insurance Solutions, Inc., is licensed as an insurance agency in all 50 states. The company offers individual policies as well as life insurance, supplemental insurance, Medicare, dental insurance, vision insurance, and long-term plans from national and regional carriers through a network of more than 3,000 licensed agents, online, or over the phone. HealthMarkets Insurance Agency also includes independent brokerages Excelsior Insurance Brokerage, Inc. and Benefitter Insurance Solutions, a San Francisco-based technology company providing employee benefit decision support tools to brokers, small businesses and their employees.
Health and Government.
In 2017 HealthMarkets unveiled #OurCare, a non-partisan website that aims to cut through the rhetoric relating to America's healthcare system in order to help the public communicate what it really wants in healthcare reform. #OurCare, which is available at OurCareBill.org, enables consumers, healthcare professionals, and business owners alike to build their own healthcare "bill" and share it with state and federal representatives.


Tracheomalacia

Tracheomalacia is a condition or incident where the cartilage that keeps the airway (trachea) open is soft such that the trachea partly collapses especially during increased airflow. The usual symptom is stridor when a person breathes out. This is usually known as a collapsed windpipe.
The trachea normally opens slightly during breathing in and narrows slightly during breathing out. These processes are exaggerated in tracheomalacia, leading to airway collapse on breathing out.
If the condition extends further to the large airways (bronchi) (if there is also bronchomalacia), it is termed tracheobronchomalacia. The same condition can also affect the larynx, which is called laryngomalacia. The term is from "trachea" and the Greek μαλακία, "softening"
Signs and symptoms.
Tracheomalacia occurs when the walls of the trachea collapse. This can happen because the walls of the windpipe are weak, or it can happen because something is pressing on it. This may include hypotonia of the trachealis muscle. The whole windpipe can be affected, or only a short piece of it. If the collapsed part of the windpipe goes past the area where the windpipe branches off into the two lungs, it is called bronchomalacia.
This problem causes noisy or difficult breathing in the first 1 to 2 months after birth. This is called congenital tracheomalacia (it was present at birth). It is not very common. Babies born with tracheomalacia may have other health issues like a heart defect, reflux or developmental delay. Some children get tracheomalacia because of other health issues. Symptoms can be mild to severe.
Symptoms inside the lung include noisy breathing that may get better when you change your baby's position or while he or she is asleep. Breathing problems that get worse during coughing, crying, feeding or colds. High-pitched sound during breathing (stridor).
High-pitched cough. Rattling noise or wheezing with breathing.
Diagnosis.
Although current diagnostic approaches include pulmonary function testing which shows a characteristic reduction in peak expiratory flow (PEF), physical examination, and imaging such as computed tomography (CT) or magnetic resonance imaging (MRI), fiberoptic bronchoscopy (FB) is considered the best diagnostic method because an inserted camera down the throat shows a direct view of the airways and lungs, detecting changes in the size or appearance of the trachea's lumen and mucosa and any signs of inflammation, fistulas, or external compressions to precisely determine the location and severity of the malacia.
Classifications.
There are three types of tracheomalacia:
Treatment.
Life is usually saved if the airway is opened via a hole in the throat. If a person survives, they may have symptoms, but usually will get better after the airway is reopened. If the symptoms are severe enough, treatment may be needed. These range from medical management over mechanical ventilation (both continuous positive airway pressure (CPAP), or bi-level positive airway pressure (BiPAP) to tracheal stenting and surgery.
Surgical techniques include aortopexy, tracheopexy, tracheobronchoplasty, and tracheostomy. The role of the nebulised recombinant human deoxyribonuclease (rhDNase) remains inconclusive.


Ekram Rasul

Ekram Rasul (date unknown - 1948) was an Indian Freedom fighter as well as a doctor who spent most of his life in the service for humanity. He was the vice president of Indian National Congress of Odisha or better known as Utkal Pradesh Congress Committee and took part in the national freedom struggle, under the supervision of Mahatma Gandhi and Harekrushna Mahtab.
He was born in Daryapur, Sungra. Due to his achievements and work are undertaken on behalf of the community, a high school was built and named in his honour. The school is located in Rai Sungra, Cuttack, Odisha. Ekram Rasul has been an inspiration to many
freedom fighters like Baba Amte and K. Kamaraj.


Microangiography

Microangiography ( ) is a type of angiography that consists of the radiography of small blood or lymphatic vessels of an organ. While most other types of angiography cannot produce images of vessels smaller than 200 µm in diameter, microangiography does just that. A microangiographic image is the result of injection of a contrast medium into either the blood or the lymphatic system and, then, enlargement of the resulting radiograph. Thus, an image is obtained in which there is contrast between vessel and surrounding tissue. It is often used in order to detect microvascular lesions in organs. But, it has been suggested that microangiography can also be used to detect tumors through visualization of tumor-induced small blood vessels. This is because tumor growths require vascularization before they can develop more rapidly. A few of the commonly used types are fluorescent, silicone rubber, and synchrotron radiation microangiography.
Common types.
Fluorescent microangiography.
Also known as FMA, fluorescent microangiography is used to visualize and quantify changes in microvasculature. It is different from other types of microangiography in that a fluorescent marker or contrast medium is used instead of something else. Fluorescein and indocyanine green are often used for this purpose.
Laser Doppler holography.
Computational imaging with lasers, ultrahigh-speed cameras, commodity graphics cards, and state-of-the-art statistical filtering algorithms, emerges as a competitive alternative to dye angiographies. This class of non-invasive microangiography techniques can be advantageously applied to the eye fundus to reveal endoluminal blood flow profiles in the retina and choroid. Laser Doppler imaging by holography provides high-contrast visualization of local blood flow in choroidal vessels in humans, with a spatial resolution comparable to state-of-the-art indocyanine green angiography.
Silicone rubber microangiography.
This type of microangiography produces a three-dimensional image that depicts the distribution of vasculature in a tissue. It is commonly used to determine changes in microvasculature.
Synchrotron radiation microangiography.
This type of microangiography uses monochromatic synchrotron radiation and a high-definition video system to provide an image of small collateral arteries with a diameter less than 100 µm.


Ian Duncan (oncologist)

Dr Ian Duncan (born 1943) is a British gynaecological oncologist.
Duncan studied medicine at the University of St Andrews and undertook trained in obstetrics and gynaecology at Dundee from 1969 to 1978, broken by period at Duke University from 1972 to 1974, specializing in gynaecological oncology.
In 1978 he obtained a position as senior lecturer st the University of Dundee, rising to be reader and honorary consultant gynaecologist and oncologist. He retired from there in 2007.
He served as president of the British Society for Colposcopy and Cervical Pathology until 1988; as president of the British Gynaecological Cancer Society from 1988 to 1991; as chair of the International Federation for Cervical Pathology and Colposcopy from 1993 to 1996; and as chair of the Scottish Cervical Screening Programme national advisory group from 1998 to 2003.
He is a Fellow of the Royal College of Obstetricians and Gynaecologists (FRCOG) and a Fellow of the Higher Education Academy (FHEA); and gave the 5th Annual Oration of the Society for Colonoscopy and Cervical Pathology of Singapore in 1998, titled "Setting Guidelines for Cervical Screening".


James Leatham Tennant Birley

James Leatham Tennant "Jim" Birley (1928-2013) of the Maudsley Hospital, London, was a psychiatrist and president of the Royal College of Psychiatrists from 1987 to 1990.
After education at Winchester College, Birley studied medicine at University College, Oxford and St Thomas's Hospital Medical School, London. He qualified in 1952 BM BCh and then from 1952 to 1954 held junior appointments. From 1954 to 1956 he was a junior specialist in the RAMC. In 1957 he was a demonstrator in pathology at St Thomas's Hospital, where he worked under William Sargant. Birley was from 1958 to 1959 a medical registrar at North Middlesex Hospital and from 1959 to 1960 a psychiatry/neurology registrar at St Thomas's Hospital. At the Maudsley Hospital he joined the staff in 1960, became a consultant in 1968, and retired in 1990. He qualified MRCP in 1958, graduated Doctor of Psychiatric Medicine in 1962, and qualified MRCPsych in 1971. In 1976 he was elected FRCP and FRCPsych.
In 1968 Birley and his colleague George Brown published a paper "Crises and life changes and the onset of schizophrenia" suggesting that "patients who were suffering from psychotic episodes were likely to have experienced some sort of recent life crisis." The paper was rejected by the "British Journal of Psychiatry", but was published by the American Sociological Association's "Journal of Health and Social Behavior" and became a classic.
He was appointed CBE in the 1990 Birthday Honours. He was president of the British Medical Association from 1993 to 1994.
Upon his death in 2013 Birley was survived by his widow, four children, and ten grandchildren. His father was the neurologist James Leatham Birley (1884–1934).


List of therapeutic monoclonal antibodies

This is a list of therapeutic, diagnostic and preventive monoclonal antibodies, antibodies that are clones of a single parent cell. When used as drugs, the International Nonproprietary Names (INNs) end in -mab. The remaining syllables of the INNs, as well as the column "Source", are explained in "Nomenclature of monoclonal antibodies".
The abbreviations in the column "Type" are as follows:
This list of over 500 monoclonal antibodies includes approved and investigational drugs as well as drugs that have been withdrawn from market; consequently, the column "Use" does not necessarily indicate clinical usage. See the list of FDA-approved therapeutic monoclonal antibodies in the monoclonal antibody therapy page.


Spinal adjustment

Spinal adjustment and chiropractic adjustment are terms used by chiropractors to describe their approaches to spinal manipulation, as well as some osteopaths, who use the term adjustment.
Spinal adjustments were among many chiropractic techniques invented in the 19th century by Daniel David Palmer, the founder of Chiropractic. Claims made for the benefits of spinal adjustments range from temporary, palliative (pain relieving) effects to long term wellness and preventive care. Despite anecdotal success, there is no scientific evidence that spinal adjustment is effective against disease.
Description.
The intention of a chiropractic adjustment is to affect or correct the alignment, motion and/or function of a vertebral joint. Specifically, they are intended to correct "vertebral subluxations", the term given to the signs and symptoms that are said by chiropractors to result from abnormal alignment of vertebrae. (p. 218) This intention forms the legal and philosophical foundation of the profession, and US Medicare law formulates it in this manner:
Chiropractic authors and researchers Meeker and Haldeman write that the core clinical method that all chiropractors agree upon is spinal manipulation, although chiropractors much prefer to use the term spinal "adjustment", a term which reflects "their belief in the therapeutic and health-enhancing effect of correcting spinal joint abnormalities." (p. 218)
The International Chiropractor's Association (ICA) states that the "chiropractic spinal adjustment is unique and singular to the chiropractic profession", and that it "is characterized by a specific thrust applied to the vertebra utilizing parts of the vertebra and contiguous structures as levers to directionally correct articular malposition. Adjustment shall be differentiated from spinal manipulation in that the adjustment can only be applied to a vertebral malposition with the express intent to improve or correct the subluxation, whereas any joint, subluxated or not, may be manipulated to mobilize the joint or to put the joint through its range of motion. Chiropractic is a specialized field in the healing arts, and by prior rights, the spinal adjustment is distinct and singular to the chiropractic profession." One author claims that this concept is now repudiated by mainstream chiropractic. The definition of this procedure describes the use of a load (force) to specific body tissues with therapeutic intent. This "load" is traditionally supplied by hand, and can vary in its velocity, amplitude, duration, frequency, and body location (p. 218) and is usually abbreviated HVLA (high velocity low amplitude) thrust.
Adjustment methods.
As the chiropractic profession grew, individual practitioners and institutions proposed and developed various proprietary techniques and methods. While many of these techniques did not endure, hundreds of different approaches remain in chiropractic practice today. Not all of them involve HVLA thrust manipulation. Most cite case studies, anecdotal evidence, and patient testimonials as evidence for effectiveness. These techniques include:
Techniques.
There are many techniques which chiropractors can specialize in and employ in spinal adjustments. Some of the most notable techniques include:
Over the years, many variations of these techniques have been delivered, most as proprietary techniques developed by individual practitioners. WebMD has made a partial list:
Effects.
Musculoskeletal disorders.
The effects of spinal adjustment vary depending on the method performed. All techniques claim effects similar to other manual therapies, ranging from decreased muscle tension to reduced stress. Studies show that most patients go to chiropractors for musculoskeletal problems: 60% with low back pain, and the rest with head, neck and extremity symptoms. (p. 219) Also the article "Chiropractic: A Profession at the Crossroads of Mainstream and Alternative Medicine" states that, “chiropractic was to be a revolutionary system of healing based on the premise that neurologic dysfunction caused by ‘impinged’ nerves at the spinal level was the cause of most dis-ease”. (p. 218) The mechanisms that are claimed to alter nervous system function and affect overall health are seen as speculative in nature, however, clinical trials have been conducted that include “placebo-controlled comparisons [and] comparisons with other treatments”. (p. 220) The American Chiropractic Association promotes chiropractic care of infants and children under the theory that “poor posture and physical injury, including birth trauma, may be common primary causes of illness in children and can have a direct and significant impact not only on spinal mechanics, but on other bodily functions”.
The effects of spinal manipulation have been shown to include: temporary relief of musculoskeletal pain, increased range of joint motion, changes in facet joint kinematics, increased pain tolerance and increased muscle strength. (p. 222) Common side effects of spinal manipulative therapy (SMT) are characterized as mild to moderate and may include: local discomfort, headache, tiredness, or radiating discomfort. (p. 222).
Non-musculoskeletal disorders.
Historically, the profession has always claimed that spinal adjustments have physiological effects on inner organs and their function, and thus affect overall health, not just musculoskeletal disorders, a view that originated with Palmer's original thesis that all diseases were caused by subluxations of the spine and other joints. With time, fewer chiropractors hold this view, with "a small proportion of chiropractors, osteopaths, and other manual medicine providers use[ing] spinal manipulative therapy (SMT) to manage non-musculoskeletal disorders. However, the efficacy and effectiveness of these interventions to prevent or treat non-musculoskeletal disorders remain controversial."
A 2019 global summit of "50 researchers from 8 countries and 28 observers from 18 chiropractic organizations" conducted a systematic review of the literature, and 44 of the 50 "found no evidence of an effect of SMT for the management of non-musculoskeletal disorders including infantile colic, childhood asthma, hypertension, primary dysmenorrhea, and migraine. This finding challenges the validity of the theory that treating spinal dysfunctions with SMT has a physiological effect on organs and their function."<ref name="Côté_Hartvigsen_Axén_Leboeuf-Yde_2/17/2021"></ref>
Safety.
There is no sufficient data to establish safety of spinal manipulations. The rate of adverse events is unknown. Adverse events are increasingly reported in randomized clinical trials of spinal manipulation but remain under–reported despite recommendations in the 2010 CONSORT guidelines. It is frequently associated with mild to moderate temporary adverse effects, and also serious outcomes which can result in permanent disability or death, which include strokes, spinal disc herniation, vertebral and rib fractures and cauda equina syndrome. Serious outcomes are very rare. About half of people reported encountering adverse effects following spinal manipulation.


Bernard Devauchelle

Bernard Devauchelle is a French oral and maxillofacial surgeon, best known for successfully completing the first face transplant in November 2005 at Amiens University Hospital.


Carl Heneghan

Professor Carl James Heneghan (born January 1968) is a British general practitioner physician, a clinical epidemiologist and a Fellow of Kellogg College. He is the director of the University of Oxford's Centre for Evidence-Based Medicine and former Editor-in-Chief of BMJ Evidence-Based Medicine. Heneghan is one of the founders of AllTrials, an international initiative which calls for all studies to be published, and their results reported. In 2013 he has been voted on to the Health Service Journal's top 100 England's most influential clinical leaders.
COVID-19 commentary.
On 21 September 2020, Heneghan alongside Sunetra Gupta, Karol Sikora and 28 signatories wrote an open letter to the UK prime minister, chancellor and chief medical officers asking for a rethink of the government's COVID-19 strategy. They argued in favour of a targeted approach to lockdowns advising that only over-65s and the vulnerable should be shielded.
During the pandemic, Heneghan has written for "The Spectator" magazine. In it he has commentated on various aspects of the UK's governments response to the COVID-19 pandemic. On 19 November 2020, he wrote an article with Tom Jefferson, a senior associate tutor and honorary research fellow at the Centre for Evidence-Based Medicine in which he criticised the science behind wearing face masks to reduce transmissions of COVID-19. In the article he stated that; “Now we have properly rigorous scientific research that we can rely on, the evidence shows that wearing masks in the community does not significantly reduce the rates of infection.” His claim was met with criticism. Sonia Sodha of "The Guardian" argued that Heneghan had made scientific errors because he had misrepresented a Danish randomised-control trial which studied infection transmission rates on people who wore face masks. This was because the Danish mask study was only focused on infection transmissions for those wearing masks, rather than on the overall community, so could not be used to make judgements on the effects of face masks on community wide transmission rates. Kamran Abbasi, executive editor of the "British Medical Journal" "(BMJ)," also criticised Heneghan's claims about face masks because he believed his interpretation of the Danish study was inaccurate. However, Abbasi stressed that he believed it was wrong that Heneghan's opinion be marked as “false information" on Facebook because, as he wrote in the "BMJ", "disagreement among experts, especially about interpretation of a study, is a common occurrence. It is the usual business of science."


Joseph F. Holson

Joseph F. Holson, an American scientist, business executive, and educator in the disciplines of toxicology and product development, served as President of WIL Research Laboratories for 20 years (1988-2008). He is known for his contributions to the fields of developmental and reproductive toxicology (DART), pharmacokinetics, and risk assessment, including extensive experience with study design, data interpretation, and . He has served in numerous U.S. EPA/FDA advisory committees and as an expert toxicology witness. He was elected to two National Academy of Sciences toxicology committees. Dr. Holson is an editor and author of the textbook "Regulatory Toxicology" and an author of two significant chapters in the textbook "Developmental and Reproductive Toxicology: A Practical Approach, Second Edition". Two of his peer-reviewed articles were recognized by the Risk Assessment Specialty Section of the Society of Toxicology as the Outstanding Published Papers Demonstrating an Application of Risk Assessment. He is the first author to receive this award in consecutive years for publications produced with two separate sets of coauthors.
Education.
Joseph Holson received his Doctorate in Physiology in 1973 from the University of Cincinnati College of Medicine, having studied under the direction of Dr. James G. Wilson in the disciplines of developmental toxicology and research pediatrics. His doctoral research investigated the relative transport capabilities of chorioallantoic and yolk sac placentae during organogenesis in the rat. Prior to his doctoral training, he earned a B.S. (1967) and M.S. (1969) in Biology from East Carolina University (receiving the Poteat Award for his research on the teratogenicity of LSD). He also completed a Traineeship in Reproductive Physiology at Louisiana State University in Baton Rouge, Louisiana, in 1970.
Career.
National Center for Toxicological Research.
Dr. Holson began his professional career in 1973 with the U.S. FDA/EPA-sponsored National Center for Toxicological Research (NCTR) in Little Rock, Arkansas, as a reproductive toxicologist. He became the Division Director in 1975 and organized a multidisciplinary research program, which became one of the nation's major federally sponsored research groups in reproductive toxicology. For the next five years, he directed the teratology and developmental toxicology research programs of the National Toxicology Program (NTP), which focused on biochemical and physiological causes of birth defects, pharmacokinetics, postnatal functional evaluations, and mechanistic studies. While at NCTR, Holson also was instrumental in developing the FDA Good Laboratory Practice (GLP) regulations and organized and wrote the first FDA training program for GLP inspectors.
During his tenure at NCTR, he also served as Assistant Professor of Physiology in the Interdisciplinary Toxicology Training Program at the University of Arkansas School of Medicine in Little Rock, Arkansas. In this capacity, he developed and taught the first graduate-level regulatory toxicology course in the country, served on PhD student committees, and was a member of the admissions committee and policy council.
Science Applications International Corporation.
Dr. Holson joined Science Applications International Corporation (SAIC) in La Jolla, California during March 1980 to establish research and development and chemical testing programs in toxicology. For the next five years, he directed SAIC’s toxicology division, which included an active reproductive toxicology research emphasis. In 1983, he was elected to SAIC's Executive Science and Technology Council. During his time at SAIC, he served as an adjunct lecturer in toxicology for the Toxicology Training Program at the University of Arizona and the Graduate Program in Public Health at San Diego State University.
Biomedical Research Institute of America.
From 1985 through 1986, he served as President of Biomedical Research Institute of America in La Jolla, California and as an independent consultant in toxicology. From 1980-1986, he also served as a member of the Board of Directors and Secretary for the San Diego Biomedical Research Institute.
WIL Research Laboratories.
In March 1987, Dr. Holson was appointed Vice President and Director of Developmental and Reproductive Toxicology at WIL Research Laboratories, Inc., in Ashland, Ohio. In August 1988, he was promoted to President and Director of WIL Research. During the next 20 years, he was responsible for all fiduciary and scientific aspects of the company’s operations. He remained scientifically active by serving as a study director upon special request, selectively reviewing data and reports, advising sponsors regarding toxicologic and product development issues, serving as a consultant to federal agencies, publishing scientific papers, giving presentations to various community and scientific organizations, and lecturing at Ashland University. He also served on Ashland University’s Science Advisory Board (1990-2008) and Board of Trustees (1993-1998), as well as Pfizer's Advisory Panel for Developmental and Reproductive Toxicology and Johnson & Johnson's Advisory Panel for Pediatric-Approved Pharmaceuticals.
Under Joe Holson's leadership, WIL Research grew from approximately 30 employees and negative profitability into a dynamic contract research organization employing more than 600 individuals, with an 18% compound annual growth rate and nearly $40 million annual EBITDA. This success was attributed to the internationally recognized scientific prowess of WIL's staff, the company's study director-centric business model (which viewed each study director as an individual business unit with scientific, project management, and marketing responsibilities), and internally developed innovations such as the industry's first protocol-driven toxicology data management software system. Holson emphasized direct scientist-to-scientist interaction as much as possible across the entire scope of each project, which gained WIL Research numerous accolades from its clients.
After nearly two decades of sustained organic growth, Holson led WIL Research through a period of private capital-financed expansion, beginning with a management buyout (in partnership with Behrman Capital) and formation of a holding company (WRH) in 2004. The expansion continued with acquisitions in the U.S. and Europe, culminating in the $500 million sale of WRH to American Capital, Ltd. (NASDAQ:ACAS) in 2007. After the sale to ACAS, he served as Vice President and Chief Scientific Officer of the global entity while continuing to serve as President and Director of WIL Research Laboratories in Ashland, Ohio until his retirement from active management duties in November 2008. He served on the Board of Directors of WRH from its inception in 2004 until February 2009.
Research highlights.
Joe Holson's research career has spanned a diverse range of test agents using a variety of experimental animal models and human studies. Building upon the foundational principles of teratology expounded upon by his doctoral advisor, James G. Wilson, his work has emphasized comparative and holistic approaches to problem-solving in the field of developmental and reproductive toxicology. These approaches included extensive collaboration between experimental toxicologists and epidemiologists, advancements in experimental design (e.g., use of replicates and unbalanced study designs) and biostatistics (e.g., use of statistical power calculations), and robust assessments of reliability and animal-human concordance of experimental toxicity findings.
Early in Holson's career, while at NCTR, he led studies that assessed the developmental toxicity of FD&C Red No. 2, an amaranth dye, and the herbicide 2,4,5‐T (a component of Agent Orange). The FD&C Red No. 2 study was a multi-laboratory collaborative effort between industry, U.S. FDA, and NCTR, while the 2,4,5-T study was a large-scale multireplicated study in various strains/stocks of mice that included replicated test groups, at least four dose levels per replicate, use of multiple stocks/strains of animals to obtain an estimate of the range in sensitivities due to genotype, complete maternal pathology, and fetal histopathology and teratological evaluation. In a follow-up statistical analysis of these data, it was calculated that 805 litters per dose group would be necessary to detect a 5% increase in embryo resorption, suggesting that no standard regulatory study is adequately capable of evaluating the dose-response threshold at low response rates. Based on these results, Holson recommended that U.S. FDA include a similar approach to standardize the statistical resolving power of tests relative to known interlaboratory and interspecies endpoint variability and variances.
Holson was also among the first developmental toxicologists to quantitatively evaluate the "litter effect" of studies in which fetal endpoints were assessed after the maternal animal was dosed. Although litter-based statistical analyses had been conducted for body weight and survival parameters, Holson insisted that litter-based corrections should also be used for fetal malformations and variations.
Based on his early work, Holson was among the first teratology researchers to assert that the various endpoints of developmental toxicity studies (intrauterine growth retardation, malformations [birth defects], functional impairment, and death) in fact constituted a continuum of responses rather than discrete outcomes, which led him to conclude that human manifestations of teratogenicity across exposure levels were most commonly multiple outcomes. Throughout his career Holson argued consistently that developmental toxicity must be viewed holistically, not simply as a group of disparate anatomical, functional, and postnatal defects, before such data can be effectively used to derive a complete estimate of human risks.
Holson was among the first to recognize that more emphasis needed to be placed on pharmacokinetic evaluations within developmental and reproductive toxicity studies in order to quantify the internal exposure to xenobiotics. His team at NCTR conducted the first series of studies designed to assess the feasibility of using pharmacokinetics to improve the design, interpretation, and extrapolation of developmental toxicity studies, in an attempt to develop methods for predicting the magnitude of endpoints in teratology and to show how interlitter variability and inter-strain and inter-species differences could be better interpreted and accounted for based on differences in the handling of a compound. Throughout his career he emphasized the use of pharmacokinetic determinations as a necessary component of developmental, reproductive, and nonclinical juvenile toxicity studies.
Holson was also the first to apply the principle of comparative ontogeny of development (physiologic age) between organ systems in various species to the interpretation of developmental, reproductive, and pediatric toxicology data.
Throughout his career, Holson served as a key advisor to numerous product development programs (INDs, NDAs, TCSA consent orders, FIFRA registrations and international product registrations) and was the principal investigator in more than 600 safety assessment studies. In these studies he emphasized his longstanding principles of holistic evaluation of data, inclusion of pharmacokinetic endpoints where possible, robust and creative experimental designs, determination of the statistical power of the study relative to known variability in endpoints, and cognizance of comparative ontogeny of development. In addition to LSD, FD&C Red No. 2, and 2,4,5-T, he was instrumental in significant developmental, reproductive, and/or nonclinical juvenile toxicity assessments of mirex, inorganic arsenic, nelfinavir (Viracept, an antiretroviral drug used to treat AIDS), (Prozac), two silicon-based ingredients found in breast implants and numerous personal care products (D4 and D5), methyl iodide, and HBOC-201 (a bovine hemoglobin-based oxygen carrier).
Retirement.
After retiring from active duties at WIL Research, Dr. Holson focused on conservation efforts on his 90-acre farm outside Ashland, Ohio. Since 1994, when he began to plant native prairie grasses and several thousand trees, he allowed the bulk of the property to gradually return to a natural state as a conservation habitat supported by Ohio's Conservation Reserve Program, including development of a 10-acre wildflower area designated as a pollinator habitat. He also maintains 45 acres of mature hardwood forest. This overall effort has facilitated Holson's personal study of conservation and animal behavior, including various flora and fauna.
Felony Drug & Sex Offender Charges
In August 2009, Dr. Holson plead guilty to the "possession of cocaine and complicity involving the illegal use of a minor in nudity-oriented material or performance", which required him to register as a Tier I sex offender. He later unsuccessfully appealed to withdraw these pleas.


UCL Ear Institute

The UCL Ear Institute is an academic department of the Faculty of Brain Sciences of University College London (UCL) located in Gray's Inn Road in the Bloomsbury district of Central London, England, next to the Royal National Throat, Nose and Ear Hospital, the UK's largest ear, nose and throat hospital.
Together with the Royal National Throat Nose and Ear Hospital, the Institute constitutes the largest centre for audiological research in Europe.
History.
In 2000 an £11 million grant from the Wellcome Trust was awarded to UCL to fund the creation of a new Centre for Auditory Research bringing together auditory research scientists and clinicians from across the university. The new centre was linked to the long-standing Institute of Laryngology and Otology (ILO) and its incorporated School of Audiology. In order to provide this cross-faculty, multidisciplinary group with a unifying identity the ILO was disestablished and the UCL Ear Institute created on 1 January 2005. Prof Tony Wright was its first director, followed by Prof David McAlpine from June 2006 and (as Interim Co-Directors) Dr Jennifer Linden and Dr Jonathan Gale from September 2015.
In December 2006 the results of tests carried out at the Institute were published which showed that many children's toys available that Christmas could damage a child's hearing. In February 2007 the Widex Noise Report, a major survey of noise levels in 41 English towns and cities authored by Deepak Prasher of the UCL Ear Institute, was published. In July 2008 the UCL Ear Institute participated in an architectural jelly competition, with the sound of the competing structures being recorded in one of the Institute's anechoic chambers.
In March 2010 a team including Professor Martin Birchall of the UCL Ear Institute performed the first windpipe transplant using a whole tissue engineered windpipe organ crafted from a patient's own stem cells. In the same month a team from the Institute began a major study to investigate the role of the brain rather than the ear in contributing to hearing difficulties. In August 2010 Aura Satz, the UCL Ear Institute's artist-in-residence, exhibited the results of her work at the Institute in 'Location, location, location' at the Jerwood Space gallery in London.
Education.
At postgraduate level the Institute currently offers the following courses:
Three- and four-year PhD programmes are available in a wide range of basic and clinical disciplines, including genetics, cell and molecular biology, auditory neuroscience and human auditory function.
Library.
The UCL Ear Institute and Action on Hearing Loss Libraries are a collaborative venture between UCL, Action on Hearing Loss (RNID) and the NHS. The libraries are based at the Royal National Throat Nose & Ear Hospital and together constitute the largest specialist collection for audiology, Deaf studies, and otorhinolaryngologic medicine in Europe. As well as providing services to staff and students at UCL, , and the University College London Hospitals NHS Foundation Trust, the libraries are open to the public and provide reference and enquiry services to anyone conducting relevant research.


Elisha Jessop

Elisha Jessop (1843 – October 24, 1918) was a Canadian doctor and politician.
Born in Norfolk County, England, Jessop emigrated to Canada with his family in 1849. They settled in the small rural community of Reach, Ontario. He was educated in various rural schools before graduating from the Toronto Normal School in 1864. After working as a teacher in several smaller communities, Jessop entered the University of Toronto, graduating in 1870. He immediately enrolled in the University's medical school, and graduated as a medical doctor in 1875. Jessop set up a practice in the town of Jordan, Ontario. After a decade there, he returned to England for further studies, eventually returning to Canada and settling in St. Catharines in 1887.
In 1898, at the age of 55, Jessop entered Ontario politics, successfully standing as the Conservative candidate for the riding of Lincoln. This began a twenty-year political career of which twelve were spent as a member of the Legislative Assembly of Ontario.
Jessop died of heart problems while still in office and is buried at Victoria Lawn Cemetery in St. Catharines.


Primitive ventricle

The primitive ventricle or embryonic ventricle of the developing heart, together with the bulbus cordis that lies in front of it, gives rise to the left and right ventricles. The primitive ventricle provides the trabeculated parts of the walls, and the bulbus cordis the smooth parts.
The primitive ventricle becomes divided by the septum inferius which develops into the interventricular septum. The septum grows upward from the lower part of the ventricle, at a position marked on the heart's surface by a furrow.
Its dorsal part increases more rapidly than its ventral portion, and fuses with the dorsal part of the septum intermedium.
For a time an interventricular foramen exists above its ventral portion, but this foramen is ultimately closed by the fusion of the aortic septum with the ventricular septum.


Bacterial capsule

The bacterial capsule is a large structure common to many bacteria. It is a polysaccharide layer that lies outside the cell envelope, and is thus deemed part of the outer envelope of a bacterial cell. It is a well-organized layer, not easily washed off, and it can be the cause of various diseases.
The capsule—which can be found in both gram negative and gram-positive bacteria—is different from the second lipid membrane – bacterial outer membrane, which contains lipopolysaccharides and lipoproteins and is found only in gram-negative bacteria.
When the amorphous viscid secretion (that makes up the capsule) diffuses into the surrounding medium and remains as a loose undemarcated secretion, it is known as a slime layer. Capsule and slime layer are sometimes summarized under the term glycocalyx.
Composition.
Most bacterial capsules are composed of polysaccharide, but some species use other materials, such as poly-D-glutamic acid in "Bacillus anthracis". Because most capsules are so tightly packed, they are difficult to stain because most standard stains cannot penetrate the capsule. To visualize encapsulated bacteria using a microscope, a sample is treated with a dark stain, such as India ink. The structure of the capsule prevents the stain from penetrating the cell. When viewed, bacterial capsules appear as a bright halo around the cell on a dark background.
Function.
The capsule is considered a virulence factor because it enhances the ability of bacteria to cause disease (e.g. prevents phagocytosis). The capsule can protect cells from engulfment by eukaryotic cells, such as macrophages. A capsule-specific antibody may be required for phagocytosis to occur. Capsules also contain water which protects the bacteria against desiccation. They also exclude bacterial viruses and most hydrophobic toxic materials such as detergents. Immunity to one capsule type does not result in immunity to the other types. Capsules also help cells adhere to surfaces. As a group where the capsule is present they are known as polysaccharide encapsulated bacteria or encapsulated bacteria.
Diversity.
The capsule is found most commonly among gram-negative bacteria:
However, some gram-positive bacteria may also have a capsule:
The yeast "Cryptococcus neoformans", though not a bacterium, has a similar capsule.
Capsules too small to be seen with an ordinary microscope, such as the M protein of "Streptococcus pyogenes", are called microcapsules.
Use in vaccination.
Vaccination using capsular material is effective against some organisms (e.g., "H. influenzae" type b, "S. pneumoniae", and "N. meningitidis"). However, polysaccharides are not highly antigenic, especially in children, so many capsular vaccines contain polysaccharides conjugated with protein carriers, such as the tetanus toxoid or diphtheria toxoid. This stimulates a much more robust immune response.


American Society for Clinical Laboratory Science

American Society for Clinical Laboratory Science or (ASCLS) is a professional organization that provides advocacy, standards setting, education (professional and continuing), personal and professional development for clinical laboratory science practitioners.
History.
The professional association began as the American Society for Medical Technology (ASMT) and is now known as the American Society for Clinical Laboratory Science (ASCLS). ASMT was organized in 1933 and incorporated in 1936. Early on, members were required to be certified by the Board of Registry (now the Board of Certification) of the American Society of Clinical Pathologists (ASCP) to ensure credibility of the society.
During the 1930s, ASMT activities included the inception of a journal, the establishment of a Constitution and Bylaws, the emergence of state charters, and educating the public about the profession. In 1947, ASMT held its first independent convention, compared to earlier national meetings which were held in conjunction with physician groups. During the 1950s, the ASMT Research Fund was established to advance research efforts. In 1962, qualifications for the clinical laboratory scientist (medical technologist) changed to include a baccalaureate degree and a new category of laboratory technician emerged. Also in the 1960s, ASMT joined the International Association of Medical Laboratory Technologists.
In the 1970s ASMT grew considerably in numbers (over 30,000 in 1976). The Professional Acknowledgment for Continuing Education (PACE) Program for validating and documenting continuing education was introduced, and the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) was formed as an independent accreditation agency. Together with Central Michigan University, ASMT provided graduate programs for laboratorians to earn master's degrees in administration or education. The ASMT launched its Future Directions Plan, and Statements of Competence. ASMT initiated the formation of the National Certification Agency (NCA) to advance "certification for the profession, by the profession."
In the 1980s, the organization sponsored the Clinical Laboratory Educators Conference (CLEC) and the Legislative Symposium. ASMT also moved its offices from Houston, Texas, to Washington, D.C., to become more involved in influencing legislation to advance the profession.
During the 1990s, ASMT changed its name to ASCLS and joined forces with the American Association for Clinical Chemistry (AACC) to hold one of the largest annual meetings of laboratorians in the country. In 1995, the National Labor Relations Board recognized medical technologists among its "professional employees."


Harry Angelman

Harry Angelman (13 August 1915 – 8 August 1996) was a British consultant paediatrician who identified and named Angelman syndrome.
Biography.
Angelman was born in Birkenhead in 1915. He qualified in Liverpool in 1938. Angelman was an enthusiast for the language and country of Italy. He observed three unrelated children who showed similar symptoms of severe intellectual disablement, lack of speech, motor disorders, and happy demeanours. He was in two minds as to whether he should publish his findings, but he described seeing a painting whose name seemed to characterise the symptoms he had observed. The painting showed a laughing boy with a puppet and was by the Renaissance artist Giovanni Francesco Caroto. His 1965 paper described what he called "puppet children", inspired by the painting.
His paper was not immediately recognised as important, but later discoveries of similar children led to the idea of renaming the condition Angelman syndrome. An American Angelman Syndrome Support Group was started in Waterlooville, Hampshire, in 1986.
Angelman travelled to talk about his discovery and his work was mentioned as important by U.S. President Bill Clinton. Angelman died due to a colon tumour.


Edmund Leser

Edmund Leser (1 May 1853, Münster – 11 December 1916, Frankfurt am Main) was a German surgeon remembered for describing the Leser-Trélat sign (named with Ulysse Trélat, 1828-1890).
He studied law in Berlin and served in the Franco-Prussian War as an artillery officer before studying medicine in Leipzig. He received his doctorate in 1880, and worked as Richard von Volkmann's assistant in Halle. He qualified as a surgeon in 1884, and became a professor in 1894, practising in Halle and Frankfurt.
He was the author of "Lehrbuch der speciellen Chirurgie in 50 Vorlesungen" (Textbook of special surgery in 50 lectures), published in several editions.