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Dunston Hill Hospital buy cheap actonel 35 mg online, near Newcastle buy actonel 35 mg on line, where he He was a member of the editorial board of The had sole charge of 200 beds for wounded service Journal of Bone and Joint Surgery from 1964 to personnel buy discount actonel 35mg line. He has been president of the orthopedic He was appointed to the Kent and Canterbury section of the Royal Society of Medicine 35mg actonel with amex, and and Ramsgate Hospitals as an honorary consult- vice president of the British Orthopedic Associa- ant in 1947 generic 35mg actonel fast delivery, a year before the beginning of the tion. At this time, fractures four surgeons who were honorary fellows of the were managed by general surgeons and orthope- British Orthopedic Association and who were dic clinics were organized by county councils or British by birth. Strange realized the For nearly 30 years, he was honorary surgeon need for a long-stay hospital for orthopedic to the Kent County Cricket Club, and served as patients in East Kent and established an orthope- honorary civilian consultant to the army from dic unit at the Royal Sea Bathing Hospital in 1967 to 1976. His East Kent colleagues inaugu- Margate, which was then being used for the man- rated an annual FG St. He died during the night preceding the 2002 success of the treatment of this disease by drugs, lecture. He was only par- 327 Who’s Who in Orthopedics Georg Friedrich Louis Ernest Adolph Gustav Gottfried STROMEYER STRÜMPELL 1804–1876 1853–1925 Georg Friedrich Louis Stromeyer of Hanover, at Ernest Adolph Gustav Gottfried Strümpell of times professor at various German universities Leipzig published a two-volume edition of the and surgeon general of the Hanoverian army, was Lehrbuch der Speciellen Pathology and Therapie one of the most powerful influences in develop- der inneren Krankheiten in 1883–1884. He was ing the surgical aspects of orthopedic surgery in among the leading internists and pathologists of the mid-nineteenth century. The masterpiece went through tribution was the popularizing of subcutaneous more than 30 editions, translated into several lan- tenotomy and the encouragement of its practice guages, with the first in English appearing in throughout the western surgical world. The volumes are still valid references in in the preface to his masterful and influential pathology with a wealth of forgotten and redis- book, he gives credit to his predecessors who covered musculoskeletal material pertinent to attempted the procedure sporadically, Stromeyer contemporary studies. His name is eponymic with applied it to deformities wherever contracted spondylitic syndrome. To appreciate the importance of subcutaneous teno- tomy, the horrendous proportion and devastating effects of open surgery in pre-Listerian days must be kept in mind. As becomes obvious in this preface, the technic of Stromeyer’s procedure was used as a wedge for the development of muscu- loskeletal surgery vis-a-vis the brace and stretch- ing era of the early days of our specialty. His first paper on the subject was published in 1833; however, the classic of Stromeyer was his book on Operative Orthopedics. Even within his lifetime, the Syme amputation was recognized as a major technical advance. Hudson, The Mechanical Surgery, described the Syme amputation as follows: “No amputation of the inferior extremity can ever compare in its value to the subject with that of the ankle joint originated by Mr. That same year he resigned the chair James Syme was born in Edinburgh in November at the University of Edinburgh, to which he had 1799, the son of well-to-do parents. He school days he was fascinated with the subject of was buried in the family vault at St. In the Scotsman Philosophy a new solvent for India rubber derived newspaper of June 20, 1870, there is a resume of from coal tar. Syme’s character and achievements as a Glasgow manufacturer named Macintosh, and surgeon. It is believed to be from the pen of had Syme followed the advice of his friends, our Joseph Lister: “The most prominent feature of rainproof garments today might be referred to as Mr. Syme’s character was uncompromising truth- “Symes” and not “Macintoshes. In 1833 he was appointed to the chair of clinical surgery at the University of Edinburgh and was given an appointment on the staff of the Royal Infirmary. In 1853 Joseph Lister migrated from London to Edinburgh and established a warm relationship with James Syme. By his marriage with Agnus, Syme’s eldest daughter, Lister became the son-in- law of the distinguished professor and acted as his assistant and substitute on many occasions. Syme introduced conservative alternatives to major amputations and is best remembered for his contribution of ankle disarticulation with preser- vation of the heel pad as an alternative to below- knee amputation. Since cartilage is more resistant to infection, the postoperative healing with this new operation, reported by Syme in 1844, was much better than with other traditional types of 329 Who’s Who in Orthopedics he was fully alive to the advantages of medical training, and sent all his five sons to a medical school—surely a unique occurrence for one family. The eldest and the youngest, Hugh Owen and John Lewis, became widely known, one as a pioneer of orthopedic surgery and the other as a leader in gynecology. Because of indifferent health he was sent to live with his grandparents at Rhos Colyn, where he went to school until the age of 13 years. During this time he sustained an injury, the effects of which were life-long. In later years he always wore a seaman’s cap with the peak Hugh Owen THOMAS tilted down over the injured eye in order to protect it from cold winds and to screen the disfigure- 1834–1891 ment. From Rhos Colyn he went on to the college at New Brighton, where he remained until the age Hugh Owen Thomas was born at Bodedern, of 17, when he became apprenticed for 4 years to Anglesey, on August 23, 1834. They derived from Evan Thomas of Maes, the University of Edinburgh at a time when Syme, of Spanish descent, who died in 1814 at the age Simpson, and Goodsir were at the height of their of 79 years.

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An example of the latter is the response sensory receptor proteins in the membrane, and for components shown by Vibrio parahaemolyticus to growth in a watery envi- that are involved in signaling a bacterium to move toward or ronment versus a more viscous environment. The adaptation involved in the chemo- cous setting, the bacteria adapt by forming what are called tactic response must have a memory component, because the swarmer cells. These cells adopt a different means of move- concentration of a compound at one moment in time must be ment, which is more efficient for moving over a more solid compared to the concentration a few moments later. This adaptation is under tight genetic control, involv- ing the expression of multiple genes. See also Antiseptics; Biofilm formation and dynamic behav- Bacteria react to a sudden change in their environment ior; Evolution and evolutionary mechanisms; Mutations and by expressing or repressing the expression of a whole lost of mutagenesis genes. This response changes the properties of both the inte- rior of the organism and its surface chemistry. A well-known example of this adaptation is the so-called heat shock Bacterial appendagesBACTERIAL APPENDAGES response of Escherichia coli. The name derives from the fact that the response was first observed in bacteria suddenly A bacterial appendage protrudes outward from the surface of shifted to a higher growth temperature. Some are highly anchored to the surface, One of the adaptations in the surface chemistry of whereas others, like the glycocalyx, are loosely associated Gram-negative bacteria is the alteration of a molecule called with the surface. Depending on the growth conditions or The entire surface of a bacterium can be covered with whether the bacteria are growing on an artificial growth glycocalyx (also known as the slime layer). The layer is made medium or inside a human, as examples, the lipopolysaccha- of chains of sugar. These chemical nature of a glycocalyx varies from one species of changes can profoundly affect the ability of antibacterial bacteria to another. A glycocalyx is easily identified in light agents or immune components to kill the bacteria. The ink does not 47 Bacterial artificial chromosome (BAC) WORLD OF MICROBIOLOGY AND IMMUNOLOGY penetrate the glycocalyx, which then appears as a halo around The bacteria called spirochetes have a modified form of each bacteria. It aids a bac- In this case, the flagella is not an appendage, in that it is not terium in attaching to a surface. Surface contact triggers the external to the bacterium, but instead is found in the interior of production of a great deal of glycocalyx. The bacteria on the the cell, running from one end of the cell to another. This phenomenon has been well ever, similar in construction to flagella. Endoflagella attach to documented for Pseudomonas aeruginosa, which forms either end of a cell and provide the rigidity that aids a cell in biofilms on surfaces in many environments, both within and turning like a corkscrew through its liquid environment. The production of glycocalyx is a vital Two other types of appendages are essentially tubes that part of the biofilm formation. The first of these is known By virtue of its chemical make-up, a glycocalyx will as spinae (singular, spina). Spinae are cylinders that flare out retain water near the bacteria, which protects the bacteria from at their base. Protection is also conferred against viruses, antibi- (spinin) that is attached only to the outer surface of the outer otics, antibacterial agents such as detergents, and from the membrane. They have been detected in a marine engulfing of the bacteria by immune macrophage cells (a pseudomonad and a freshwater bacterial species. The mass of glycocalyx- tion is triggered by environmental change (pH, temperature, enclosed bacteria becomes too large for a macrophage to and sodium concentration). For example, encapsulated strains of Streptococcus extremely resilient, surviving treatment with harsh acids and pneumoniae kill 90% of the animals it infects. Suggested functions include buoyancy, promoters ple of the protection conferred by the glycocalyx, Pseudo- of bacterial aggregation, and as a conduit of genetic exchange. They are smaller in diameter than parts without glycocalyx and bacteria freed from the glycoca- spinae. Relatively Glycocalyx material is easily removed from the bacte- short pili are important in the recognition of receptors on the rial surface.

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