Fifty centuries of right-handedness: the historical record.

A survey of more than 5000 years of art work, encompassing 1180 scorable instances of unimanual tool or weapon usage, revealed no systematic trends in hand usage. The right hand was used in an average of 93 percent of the cases, regardless of which historical era or geographic region was assessed.

Impact of genetic manipulation on society and medicine.

Human beings have been manipulating the genetic characteristics plants and animals since the introduction of agriculture indirect manipulation of human genes occurred with widespread use of public health and medical measures that preserve genes causing disease. The production of biologicals by DNA technology raises few ethical problems. Predictive medicine in which genetic markers (including DNA variants) are used for antenatal and preclinical diagnosis of genetic diseases and susceptibilities poses new questions of confidentiality, private versus societal goals, and self-determination. When normal DNA is used to treat the somatic cells of patients with hemoglobinopathies and other genetic diseases, no new ethical problems arise beyond those presented by an novel theory. In contrast, manipulation of DNA in human fertilized eggs would constitute a qualitative departure from previous therapies since this would affect future generations. In order to be able to make wise decisions on these matters the public must be well informed. Thus, formal and informal education in human biology and genetics must be improved at all levels.

KIE: The director of the Center for Inherited Diseases at the University of Washington reviews the current status of applications of recombinant DNA techniques to the manipulation of human genetic characteristics and considers their social and ethical implications. Motulsky distinguishes the relatively conventional dilemmas posed by gene therapy from the qualitatively different problems raised by manipulation of DNA in human fertilized eggs so as to affect future generations. He advocates strengthened formal and informal programs to educate the public about developments in molecular biology and genetics.

Antiglycolipid autoantibody detected in the sera from systemic lupus erythematosus patients.

A high incidence of autoantibody against the neutral glycolipid "asialo GM1" was observed in sera from patients with systemic lupus erythematosus (SLE) with neurological disorders, using an immunoflocculation test. The sera from 14 out of 17 cases of SLE with neurological disorders showed antibody activity against asialo GM1 but not against the following glycolipids: asialo GM2 GM1, and galactocerebroside. In another 87 cases of SLE without any history of seizures, as well as 61 cases of other autoimmune diseases (rheumatoid arthritis, progressive systemic sclerosis, mixed connective tissue disease, etc.) and 20 cases of various neurological diseases (epilepsy, multiple sclerosis, etc.), no antibody could be detected. In general, the antibody titer was high several months, even years, before and/or after the seizure, though the titer was low at the time that patients showed definite neurological symptoms. Immunochemical characterization with Sephadex G-200 chromatogrphy and protein A-Sepharose CL-4B affinity column indicated that the antiasialo GM1 was probably an autoantibody belonging to the immunoglobulin G class. The above results suggest that this newly found autoantibody plays a role in the pathogenesis of neurological disorders accompanying SLE.

Drivers of contraceptive use choice in Zambia

Modern approaches of birth control have emerged as broadly accepted family planning methods in replacement of traditional alternatives. However, the effectiveness of modern contraceptives has been challenged by serious side effects, either experienced or expected, with inhibiting consequences on the acceptability and utilisation of family planning service. This paper disentangles the drivers of none-use, traditional and modern contraceptive use in Zambia using the 2018 Zambian Demographic Health Surveys (DHS) data. The Conditional logit choice modelling technique is employed to account not only for the differences in alternative contraceptive options but also the socioeconomic and demographic characteristics of individual woman making the choice. Empirical results indicate that educated, older and poorer women are likely to adopt the traditional contraceptive methods whereas employed women are indifferent between traditional and modern birth control options. Furthermore, Christian women and those from other religions as well as women with no education prefer no birth control method. The study concludes that employment has the potential to serve as an alternative and safer birth control tool in developing countries and namely in Zambia. Therefore, government's effort to expand family planning program should mainly target non-educated women while promoting safer contraceptive methods. This can be achieved through women education and job creation. (Afr J Reprod Health 2022; 26[5]:13- 27).

Ventricular fibrillation: how do we stop the waves from breaking?

Combined experimental and theoretical developments have demonstrated that in addition to preexisting electrophysiological heterogeneities, cardiac electrical restitution properties contribute to breakup of reentrant wavefronts during cardiac fibrillation. Developing therapies that favorably alter electrical restitution properties have promise as a new paradigm for preventing fibrillation.

Morphometric analysis of calcaneal (heel) spurs in ancient and modern Anatolian populations / Análisis morfométrico de los espolones calcáneos en poblaciones de Anatolia antiguas y modernas

SUMMARY: Heel spurs are the bony protrusion seen especially on the dorsal and plantar face of the calcaneus bone at the attachment site of the muscles. It was aimed herein to obtain data about the life styles, daily lives, and especially the socioeconomic structures of modern and ancient Anatolian populations by evaluating the prevalence, location, age, and gender differences of heel spurs on the calcaneus and comparing these findings between the populations. Herein, the 251 calcaneus bones of 137 skeletons, which had been previously analyzed paleodemographically and dated to the Middle Ages, and 68 calcaneus bones belonging to a modern population, whose gender was unknown but lived in Anatolia, were examined in terms of heel spurs. In the current study, the presence of dorsal, plantar, or both dorsal/plantar heel spurs on these in 251 calcaneus bones was 43.9 %, 11.1 %, and 10.3 %, respectively. The presence of dorsal, plantar, or both dorsal/plantar heel spurs was determined as 22 %, 3 %, and 1.5 %, respectively, among the 68 calcaneus bones belonging to the modern population. When a comparison was made of the current study with studies in the literature on modern and prehistoric populations, a higher prevalence of heel spurs was found in prehistoric samples than in modern populations. It is our belief that this situation may have derived from the heavy labor force, environmental, or sociocultural differences in ancient Anatolian populations, insufficiency of vital materials due to inadequate industrial conditions, and the solution of anatomical disruption. In addition, the findings determined herein will guide the development of future and industrial studies on the foot and foot structure.

RESUMEN: Los espolones del talón son la protuberancia ósea que se ve especialmente en la cara dorsal y plantar del hueso calcáneo en el sitio de inserción de los músculos. El objetivo de este trabajo consistió en obtener datos sobre los estilos de vida, la vida cotidiana y, especialmente, las características socioeconómicas de las poblaciones anatolias modernas y antiguas mediante la evaluación de la prevalencia, la ubicación, la edad y las diferencias de sexo de los espolones calcáneos y comparar estos hallazgos entre los poblaciones. La muestra consistió en 251 calcáneos correspondientes a 137 esqueletos, que habían sido previamente analizados paleodemográficamente y fechados en la Edad Media; también se incluyeron 68 calcáneos pertenecientes a una población moderna de Anatolia, sin distinción de sexo. De la muestra de 251 calcáneos, se encontraron espolones calcáneos dorsales, plantares y dorsales/plantares, en el 43,9%, 11,1 % y 10,3 %, respectivamente. La presencia de espolones calcáneos dorsales, plantares y dorsales/plantares se determinó en el 22%, 3% y 1,5%, respectivamente, entre los 68 calcáneos pertenecientes a la población moderna. Cuando se realizó una comparación del estudio actual con la literatu- ra sobre poblaciones modernas y prehistóricas, se encontró una mayor prevalencia de espolones calcáneos en muestras prehistóricas que en poblaciones modernas. Creemos que esta situación puede haberse derivado a la gran fuerza de trabajo, y las diferencias ambientales o socioculturales en las antiguas poblaciones de Anatolia, la insuficiencia de materiales vitales debido a las condiciones industriales inadecuadas produjo la alteración anatómica. Además, los hallazgos aquí determinados guiarán el desarrollo de estudios futuros e industriales sobre la estructura del pie.

Prospects on the increase of radiological examinations in Korea

Due to technological advances and the establishment of evidence-based medicine, radiological examinations are playing a crucial role in modern medicine, as a result of which they have been steadily increasing, and the rate of increase has intensified in the 2000s. Although this is a global phenomenon, the increase of radiological examinations in Korea is also high due to the introduction of the National Health Insurance Coverage Expansion Policy, so-called Moon Jae-in Care, for ultrasonography and magnetic resonance imaging. For accurate and rapid diagnosis of diseases, it is necessary for doctors to order appropriate radiological studies. However, the increase in radiological examination has created many problems, such as increased medical costs, decreased diagnostic accuracy due to radiologist burnout, and increased patient exposure to radiation. To reduce unnecessary imaging studies, a number of measures could be deployed including the development of clinical guidelines to select appropriate radiological examinations for each clinical situation.

Sex differences in biologically active and immunoreactive gonadotropins in the fetal circulation of rhesus monkeys.

To study the ontogenesis of fetal pituitary gonadotropin secretion in the rhesus monkey, LH was measured in fetal serum (n = 95) from days 47-163 of gestation with a mouse Leydig cell bioassay. In addition, FSH was measured in some samples (n = 46) by RIA. Concentrations of LH determined by bioassay were compared with concentrations determined by two different RIAs for rhesus LH. Values obtained by bioassay were highly correlated with values obtained with the rhesus:anti-hCG RIA, but not with values obtained with the ovine:antiovine RIA. Levels of biologically active LH (LER-1909-2) in female fetuses reached peak values of 15-20 micrograms/ml between 80-120 days of gestation, and then declined near term. Levels of biologically active LH in fetal males remained relatively low (2-4 micrograms/ml) throughout gestation. From 79-163 days of gestation, concentrations of FSH and LH in fetal sera were significantly greater in females than in males. The level of biologically active LH in the maternal circulation remained low (<1.0 microgram/ml) throughout gestation, and there were no differnces in LH concentrations between matched samples from umbilical artery and vein (n = 24). The data demonstrate an unequivocal sex difference in concentrations of LH and FSH in the circulation of fetal rhesus monkeys and suggest the presence of a gonadal-hypothalamic-pituitary-negative feedback loop that is operative in fetal males but not in females.

Circannual rhythms in steroid receptor concentration and nuclear binding in the chick oviduct.

For 3 yr, 1-yr synchronized circannual rhythms were found for the chick oviduct weights, amounts of soluble protein, concentrations of the progesterone receptor in this organ, and capacity of this steroid-receptor complex in cytosol in bind in vitro to deoxyribonucleoprotein acceptor sites. By fitting the data with 1-yr cosine curves, statistically significant circannual rhythms were described for all of these rhythms, with high values occurring in the late summer and low ones in the late winter. Interestingly, no statistically significant rhythms were described for the binding of the progesterone-receptor complex to pure DNA. By analyzing both receptor and nuclear protein preparations isolated at different times of the year, changes in the receptor were found to underlie the rhythms in nuclear binding in vitro. Studies in vivo revealed similar rhythms for the nuclear translocation and binding of both progesterone and estrogen and for the progesterone-induced changes in RNA polymerase II activity. In each instance, marked reductions in nuclear binding and steroid-induced changes in the polymerase activity occurred in the late winter. Blood levels of the 3H-labeled steroids did not vary throughout the year, so differences in whole body metabolism and disposition of the steroids were ruled out as factors in the in vivo rhythms. These results support the validity of the cell-free binding assays and the hypothesis that certain protein-DNA complexes, and not pure DNA, represent the natural acceptor sites for the progesterone receptor. Furthermore, these rhythms emphasize the fact that steroid receptors are not constant entities but change in both amount and function. Although the exact cause of these rhythms in the progesterone receptor is not understood, a rhythm in estrogen action on the oviduct is strongly suggested. These rhythms in the steroid receptors may play a role in seasonal reproduction and molting in animals.

The "brave new world" of transmissible spongiform encephalopathy (infectious cerebral amyloidosis).

The story of transmissible human spongiform encephalopathy, from its origins to the present time, enjoys the commentary of a cast of characters from Shakespeare's imaginary island in The Tempest, with a brief visit to the real island of Tasmania for a bird's eye view of the prion, and some concluding thoughts about the current state of research in the netherworlds of molecular biology and physical chemistry.

1977 annivesaries.

The author recalls this year's anniversaries of events and individuals prominent in the history of medicine, psychiatry, and psychology and examines their practical and theoretical contributions.

Psychiatry in Spain: past and present.

The authors discuss the contributions and history of psychiatry in Spain on the basis of extensive literature review and on-site observations. The history of Spanish psychiatry is a rich one, including pioneering efforts in the establishment of mental institutions and a strong traditional alliance between psychiatry and literature. However, the authors note that Spanish psychiatrists today are less innovative than their counterparts in other countries. They emphasize the historical and cultural context of the discipline, with illustrations of the importance of the church, attitudes toward the family, and other sociocultural factors.

Concussion: the history of clinical and pathophysiological concepts and misconceptions.

Concussion is a well-recognized clinical entity; however, its pathophysiologic basis remains a mystery. One unresolved issue is whether concussion is associated with lesser degrees of diffuse structural change seen in severe traumatic brain injury, or is the mechanism entirely caused by reversible functional changes. This issue is clouded not only by the lack of critical data, but also by confusion in terminology, even in contemporary literature. This confusion began in ancient times when no distinction was made between the transient effects of concussion and severe traumatic brain injury. The first clear separate recognition of concussion was made by the Persian physician, Rhazes, in the 10th century. Lanfrancus subsequently expanded this concept as brain "commotion" in the 13th century, although other Renaissance physicians continued to obscure this concept. By the 18th century, a variety of hypotheses for concussion had emerged. The 19th century discovery of petechial hemorrhagic lesions in severe traumatic brain injury led to these being posited as the basis of concussion, and a similar logic was used later to suggest diffuse axonal injury was responsible. The neuropathology and pathophysiology of concussion has important implications in neurology, sports medicine, medicolegal medicine, and in the understanding of consciousness. Fresh approaches to these questions are needed and modern research tools, including functional imaging and experimental studies of ion-channel function, could help elucidate this puzzle that has evolved over the past 3,000 years.

An examination of the spectrum of anatomic defects and variations found in eight cases of trisomy 13.

We report the anatomic variations found in four additional cases of trisomy 13. Data from these and four previous cases [Colacino and Pettersen, 1978] are utilized to define a muscle phenotype. Previously unreported defects include the bilateral presence of cervical ribs and the bilateral absence of 12th thoracic ribs in five of the eight cases. One unusual developmental defect of the great vessels is also described. The findings suggest that a definitive diagnosis of trisomy 13 can be made on the basis of six muscle variations.

Detection of leprosy in ancient human skeletal remains by molecular identification of Mycobacterium leprae.

We isolated ancient DNA from skeletal remains obtained from a South German ossuary (approximately 1400-1800 AD) and from a 10th century Hungarian cemetery partially indicating macromorphologic evidence of leprosy. In samples taken of 2 skulls from Germany and of 1 hard palate from Hungary, Mycobacterium leprae-specific fragments of RLEP1 and RLEP3 were amplified using polymerase chain reaction (PCR), thereby confirming their specificity by sequencing. In another case, PCR with primers targeting IS6110 of Mycobacterium tuberculosis gave positive results only for a mandibular specimen. No signal for any mycobacterial DNA was observed in samples from 2 Hungarian foot bones. In ancient material, osseous involvement of M leprae may be detected and distinguished from other mycobacterial infections by specific PCR. In the small bones of leprous hands and feet, not enough M leprae DNA seems to be present for detection. This supports the view that rhinomaxillary leprous alterations result from direct bacterial involvement, while osseous mutilations of hands and feet result from a nervous involvement and/or secondary infections due to small lacerations of the overlying soft tissues.

The global eradication of smallpox.

On May 8, 1980, the 33rd World Health Assembly declared the world free of smallpox. This followed approximately 2 1/2 years after the last documented naturally occurring case of smallpox was diagnosed in a hospital worker in Merca, Somalia. A major breakthrough for the eventual control of this disease was the discovery of an effective vaccine by Edward Jenner in 1796. In 1966 the World Health Assembly voted a special budget to eliminate smallpox from the world. At that time, smallpox was endemic in more than 30 countries. Mass vaccination programs were successful in many Western countries; however, a different approach was taken in developing countries. This approach was known as surveillance and containment. Surveillance was aided by extensive house-to-house searches and rewards offered for persons reporting smallpox cases. Containment measures included ring vaccination and isolation of cases and contacts. Hospitals played a major role in transmission in a number of smallpox outbreaks. The World Health Organization is currently supporting several control programs and has not singled out another disease for eradication. The lessons learned from the smallpox campaign can be readily applied to other public health programs.

The argument from design: what is at stake theologically?

This article offers a brief overview of the argument for God's existence grounded in the evidence of design. It pays particular attention to the way the argument has evolved over time and in relation to changing scientific perspectives. The argument from design has in fact been formulated and reformulated in response to the discoveries and challenges it has encountered from the field of science. The conclusion of the article explores the theological importance of this argument with respect to its extent and its limits.

The 'first to perish'. Child euthanasia in the Third Reich.

In an attempt to improve racial fitness, racial policy in the Third Reich targeted many groups, including physically and mentally handicapped children. An early program identified disabled children who were systematically selected and then transferred to various hospital centers where they were actively euthanatized. The program, directed by mainstream German physicians, was begun on the eve of war and was a harbinger of the evils to come. This article highlights the "scientific thought" that provided the rationale for this policy together with the details of implementation of the active euthanasia program and profiles one of the major participants, Werner Catel, DrMed, who was a distinguished pediatrician.