Ethical decision-making and its teaching.
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Biomedical subjects
Publications and source records attributed to T Hongladarom.
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A patient underwent tracheo-esophageal anastomosis following repeated episodes of aspiration pneumonia after the resection of a meningioma at foramen magnum. The surgery eliminated the intractable problem with aspiration. This procedure is reversible, and restoration of the laryngeal function can be accomplished when the patient has recovered neurologically. If adequate neurologic recovery does not occur, the anastomosis can be left intact indefinitely.
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The effect of needle electromyography on serum creatine phosphokinase (CPK) levels has remained unclear despite the diagnostic implications. Serum CPK was serially assayed for changes before and after electromyography (EMG) in two healthy persons and ten persons having low back pain, while they remained at total bed rest. Mean curves showed a peak at 6 hours post-EMG and a return to baseline 48 hours post-EMG. The mean peak value was 1.5 times the baseline. Only one sample exceeded the normal range and it was from a patient with frank positive waves and fibrillation potentials. Correcting for dilution of CPK released, by body weight and for total trauma, by number of needle insertions did not modify the results. The time course and magnitude of elevation of CPK parallel those reported for post exercise changes but are much less than those reported to follow myocardial infarction. In the differential diagnosis of myopathies, care must be taken to ensure that the combination of needle electromyography, exercise, diurnal variation and active denervation does not lead to a "false-positive" elevation of CPK above the normal range. Needle electromyography by itself should not induce a false-positive CPK level in a normal person and no significant changes in CPK levels are likely to occur within two hours after the study.
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By use of a micro technique for producing extracts of spinach mesophyll cells, chloroplasts were isolated in a state wherein they displayed microscopically visible, reversible osmotic properties. Swollen spherical chloroplasts treated with hypertonic sucrose or mannitol media, but not NaCl, could be shrunken to a state resembling their disk appearance in living cells. Reversible osmotic behavior was more easily demonstrated when the chloroplasts were initially isolated from cells in a relatively low osmolar concentration in contrast to using 0.25 m sucrose or more concentrated media. Individual chloroplasts could be swollen and contracted repeatedly through as many as 4 cycles. The relationship between the capacity for osmotic behavior and chloroplast appearance in cell extracts is discussed.