The history of physical diagnosis started with Hippocrates and his school. History taking, inspection, palpation, and sometimes immediate auscultation and examination of the urine are fundamental diagnostic tools. The Hippocratic Corpus and Galen’s authoritative theoretical writings dominate medical thinking for over 1000 years. Clinical examination advances through Vesalius and Morgagni’s discoveries of human dissection (1543) and pathologic anatomy (1761) respectively. The Vienna school through Auenbrugger introduces percussion in 1760. The Paris school formally establishes physical diagnosis with the invention of the stethoscope by Laennec in 1816.
Medical History Taking ; Percussion

China ; Education, Medical/history* ; History, 20th Century ; Humans ; Laboratories, Hospital/history* ; Portraits as Topic

Anesthetics, Local ; chemistry ; pharmacology ; toxicity ; Central Nervous System ; drug effects ; Ethyl Chloride ; chemistry ; pharmacology ; toxicity ; Humans ; Inhalation ; Male ; Medical History Taking ; Neurologic Examination ; Patient Care Management ; methods ; Psychotropic Drugs ; chemistry ; pharmacology ; toxicity ; Substance-Related Disorders ; etiology ; physiopathology ; psychology ; therapy ; Treatment Outcome ; Volatilization ; Young Adult

China ; History, 21st Century ; Societies, Medical ; history ; Thoracic Surgery ; history

PURPOSE: This study investigated predictive factors for severe neonatal thrombocytopenia, which greatly increases the need for intensive care and is associated with a high mortality rate in premature infants. Factors adopted for prompt identification of at-risk newborns include blood test results and birth history. This study analyzed the relationship between the presence of severe neonatal thrombocytopenia and the mortality rate. The causes of thrombocytopenia in premature infants were also examined. METHODS: This retrospective study evaluated 625 premature infants admitted to the neonatal intensive care unit (NICU) at Chung-Ang University Medical Center. The neonates were classified into 3 groups according to the severity of thrombocytopenia: mild (100×10⁹/L≤platelet < 150×10⁹/L), moderate (50×10⁹/L≤platelet < 100×10⁹/L), or severe (platelet < 50×10⁹/L). Analysis of blood samples obtained at the onset of thrombocytopenia included platelet count, white blood cell (WBC) count, hemoglobin level, hematocrit level, absolute neutrophil count, and high-sensitivity C-reactive protein level. RESULTS: Of the 625 premature infants admitted to our NICU, 214 were detected with thrombocytopenia. The mortality rate in thrombocytopenic neonates was 18.2% (39/214), whereas a mortality rate of only 1.0% was observed in non-thrombocytopenic neonates. The major causes of thrombocytopenia were perinatal insufficiency and sepsis in premature infants. Severe thrombocytopenia was noted more frequently in premature infants with higher WBC counts and in those with a younger gestational age. CONCLUSION: Platelet count, WBC count, and gestational age are reliable predictors for severe neonatal thrombocytopenia. The major causes of thrombocytopenia were perinatal insufficiency and sepsis in premature infants.
Academic Medical Centers ; C-Reactive Protein ; Classification ; Critical Care ; Gestational Age ; Hematocrit ; Hematologic Tests ; Humans ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Leukocytes ; Mortality ; Neutrophils ; Platelet Count ; Reproductive History ; Retrospective Studies ; Sepsis ; Thrombocytopenia ; Thrombocytopenia, Neonatal Alloimmune

No abstract available.
History, 19th Century ; History, 20th Century ; Medical Missions, Official/history ; Missionaries ; Religious Missions/history

Ovaries of 21 bitches presented with gynecopathies were surgically removed and histologically examined. Standard histological, as well as immunohistochemical, classification of 193 cystic structures resulted in the classification of 72 cysts of subsurface epithelial structures (SES), 61 follicular cysts (FCs), 38 cystic rete ovarii (CRO), 13 lutein cysts (LCs), and 9 non-classifiable cysts (NCCs). In addition to the histological classification, results were interpreted according to subject medical history, clinical examination outcome, and macroscopic observations during ovariohysterectomy. Dogs with ovarian cysts (OCs) and associated reproductive perturbations were mostly nulliparous, of large breed, and had an average of 9.5 ± 3 years. Prolonged or shortened inter-estrus intervals of past heats, however, seemed to be relatively low-risk factors for the development of OCs in dogs. Furthermore, we provide histological observations of a rarely seen canine LC including a degenerated oocyte in the central cavity.
Animals ; Classification ; Dogs ; Female ; Follicular Cyst ; Hot Temperature ; Immunohistochemistry ; Lutein ; Medical History Taking ; Oocytes ; Ovarian Cysts ; Ovary

OBJECTIVE: Lynch syndrome is a cancer predisposition syndrome caused by germline mutation of DNA mismatch repair (MMR) genes. Lynch syndrome only causes about 0.4% of cases of ovarian cancer, which suggests that universal screening may not be cost-efficient. However, the frequency of Lynch syndrome in ovarian cancer is unclear in the Asian population. The goal of the study was to investigate a screening strategy using family history. METHODS: The subjects were 129 patients with ovarian cancer. Clinical and family history were collected using a self-administered questionnaire, and Society of Gynecologic Oncology (SGO) criteria 2007 and PREMM5 were used for risk assessment. Microsatellite instability, immunohistochemistry, and methylation of MMR genes were analyzed. RESULTS: Of the 129 cases, 25 (19.4%) met the SGO criteria, and 4 of these 25 had MSI-high and MMR deficiency. Two cases had loss of MSH2 and MSH6, indicating MSH2 mutation, and the other two had loss of MLH1 and PMS2, including one without MLH1 methylation indicating MLH1 mutation. These results show that screening using family history can detect Lynch syndrome in 12.0% (3/25) of ovarian cancer cases. The 3 cases were positive for PREMM5, but negative for Amsterdam II criteria and revised Bethesda guidelines. Genetic testing in one case with MSH2 and MSH6 deficiency confirmed the diagnosis of Lynch syndrome with MSH2 mutation. CONCLUSION: This is the first study of screening for Lynch syndrome in ovarian cancer using clinical and family history in an Asian population. This approach may be effective for diagnosis in these patients.
Asian Continental Ancestry Group ; Colorectal Neoplasms, Hereditary Nonpolyposis* ; Diagnosis ; DNA Mismatch Repair ; Genetic Testing ; Germ-Line Mutation ; Humans ; Immunohistochemistry ; Mass Screening* ; Medical History Taking ; Methylation ; Microsatellite Instability ; Ovarian Neoplasms* ; Risk Assessment*

PURPOSE: This study aimed to evaluate the clinical course and prognostic factors of acquired third, fourth, and sixth cranial nerve (CN) palsy grouped according to etiology. METHODS: This study involved a retrospective review of the medical records of 153 patients who were diagnosed with acquired paralytic strabismus from January 2004 to July 2015. Outcomes, recovery rates, and time to recovery were investigated according to the affected CN: CN3, CN4, and CN6 palsies. The patients were classified into four groups based on etiology: idiopathic, traumatic, neoplastic, and vascular. RESULTS: The mean age of the patients was 59.8 ± 14.5 years and the mean follow-up period was 10.8 months. Out of the 153 patients, 63 (41.2%) had CN3 palsy, 35 (22.9%) had CN4 palsy, and 55 (35.9%) had CN6 palsy. The most common causes were vascular related (54.9%), followed by idiopathic (28.1%), trauma (8.5%), and neoplasm (5.88%). About 50% of the patients recovered within six months. Among the four etiologic groups, the idiopathic group showed the best prognosis because about 50% of the patients in this group recovered within three months. This was followed by the vascular, traumatic, and neoplastic groups. Cox proportional hazard analysis revealed a significant association between the baseline prism diopter and recovery rate. CONCLUSIONS: The prognosis and natural history of paralytic strabismus vary depending on its cause. The vascular group had the best recovery rate and shortest recovery time, whereas the neoplastic group required the longest time to recover.
Abducens Nerve Diseases* ; Abducens Nerve* ; Cranial Nerve Diseases ; Follow-Up Studies ; Humans ; Medical Records ; Natural History ; Paralysis ; Prognosis ; Retrospective Studies ; Strabismus

As well for optimized emergency management in individual cases as for optimized mass medicine in disaster management, the principle of the medical doctors approaching the patient directly and timely, even close to the site of the incident, is a long-standing marker for quality of care and patient survival in Germany. Professional rescue and emergency forces, including medical services, are the "Golden Standard" of emergency management systems. Regulative laws, proper organization of resources, equipment, training and adequate delivery of medical measures are key factors in systematic approaches to manage emergencies and disasters alike and thus save lives. During disasters command, communication, coordination and cooperation are essential to cope with extreme situations, even more so in a globalized world. In this article, we describe the major historical milestones, the current state of the German system in emergency and disaster management and its integration into the broader European approach.
Disaster Medicine ; history ; Emergency Medical Services ; history ; Emergency Medicine ; history ; Germany ; History, 20th Century ; History, 21st Century ; Humans ; Registries