"Radiation hormesis" is the name given to the putative stimulatory effects of low level ionizing ... more "Radiation hormesis" is the name given to the putative stimulatory effects of low level ionizing radiation (generally in the range of 1-50 cGy of low-LET radiation). Based on historical and pharmacologic principles reminiscent of some of the major tenets of homeopathy, most of these effects are now generally ascribed to protective feedback systems that, upon exposure to low concentrations of toxins, proceed to stimulate metabolic detoxification and repair networks. The activation of these networks may then result in net beneficial effects on the cell, organism or species. Discussions of possible stimulatory effects of low levels of ionizing radiation have recently become entangled with the separate but related question of whether a threshold dose level exists on the radiotoxicologic dose-response curve. This review summarizes some of the relevant historical and scientific data bearing on the question of radiation hormesis. We find the data in support of most of the hormesis postulates intriguing but inconclusive.
Written by medical students for medical students, this manual provides concise, rapidly digestibl... more Written by medical students for medical students, this manual provides concise, rapidly digestible information about those aspects of clinical medicine that cannot effectively be learnt in the classroom setting. The book includes: chapters on write-ups and presentations - these are two major sources of angst for medical students on their rotations that are usually not covered well in the ICM course, but learnt on the job; new drug appendix - to make it easier for students to get a quick handle on any drug they are likely to encounter; chapters on diagnostic tests (lab, X-ray, ECG) - succinct coverage of when and why to order them, and what to do with the results.
Cancer therapies based on administered radionuclides require accurate information on tumor dose. ... more Cancer therapies based on administered radionuclides require accurate information on tumor dose. One of the major factors influencing the distribution of absorbed-dose characteristics is the uniformity of the radiolabel distribution in tissue. To study the effect of nonuniformities, we used image analysis techniques to measure automatically the coordinates of autoradiographic grains (sources) and cell nuclei in cut sections from three different tumors, following treatment with radiolabeled antibodies. The spatial distribution data of sources and cell nuclei from these tumor sections were assessed and the pattern of energy deposition in the cell nuclei calculated, assuming that each autoradiograph grain corresponded to a source of the alpha emitter astatine-211 (211At) or the beta emitter yttrium-90 (90Y). The distribution of deposited energy obtained for the real grain distributions was compared to the distribution assuming a locally uniform source distribution, i.e., simulating grain count averaging as produced by a microdensitometric method within a 100 x 100 microns 2 frame size (frame averaging), and a uniform distribution across the entire section (section averaging). The results show first that when the grain distribution is uniform, the average dose within the section is an adequate estimate of the dose to the cell nuclei. Second, when the grain distribution is nonuniform, the distribution of doses to the cell nuclei is significantly less when calculations use the measured grain coordinates, or frame averaging, than when section averaging is used. Third, when the sources are located on or in the cells, both frame and section averaging produce underestimates of the dose to the cell nuclei.
Coincident lymphoma and pregnancy is rare, occurring in only one of 1,000 or fewer deliveries. Pa... more Coincident lymphoma and pregnancy is rare, occurring in only one of 1,000 or fewer deliveries. Patients with Hodgkin's disease usually present with typical manifestations, and most studies suggest that the disease probably has little or no effect on the pregnancy and vise versa. In contrast, patients with non-Hodgkin's lymphoma often have unusual manifestations and their diagnosis is frequently delayed. These patients usually have aggressive, advanced-stage disease and a poor outcome. The optimal management of these women requires special considerations. Treatment during the first trimester is associated with significant risk to the developing fetus and should be avoided. Women requiring treatment at this time should have a therapeutic abortion. Beyond the first trimester, the management options for women with Hodgkin's disease include observation until disease progression or delivery, single-agent vinblastine, modified or standard combination chemotherapy, and radiation therapy (with appropriate shielding). Because of their poor prognosis, women with non-Hodgkin's lymphoma should receive standard chemotherapy (despite the potential risk to the developing fetus).
International Journal of Radiation Oncology Biology Physics, Nov 1, 2006
ABSTRACT The aim of this study was to review advances in radioimmunotherapy (RIT) for non-Hodgkin... more ABSTRACT The aim of this study was to review advances in radioimmunotherapy (RIT) for non-Hodgkin's lymphoma (NHL) and to discuss the role of the radiation oncologist in administering this important new form of biologically targeted radiotherapy. A review of articles and abstracts on the clinical efficacy, safety, and radiation safety of yttrium Y 90 (90Y) ibritumomab tiuxetan (Zevalin) and iodine I 131 tositumomab (Bexxar) was performed. The clinical efficacy of RIT in NHL has been shown in numerous clinical trials of 90Y ibritumomab tiuxetan and 131I tositumomab. Both agents have produced significant responses in patients with low-grade, follicular, or transformed NHL, including patients with disease that had not responded or had responded poorly to previous chemotherapy or immunotherapy. Reversible toxicities such as neutropenia, thrombocytopenia, and anemia are the most common adverse events with both agents. Radioimmunotherapy is safe and effective in many patients with B-cell NHL. 90Y ibritumomab tiuxetan and 131I tositumomab can produce clinically meaningful and durable responses even in patients in whom chemotherapy has failed. Treatment with RIT requires a multispecialty approach and close communication between the radiation oncologist and other members of the treatment team. The radiation oncologist plays an important role in treating patients with RIT and monitoring them for responses and adverse events after treatment.
The benefits of radiation therapy (RT) as part of a treatment regimen for cancer must be weighed ... more The benefits of radiation therapy (RT) as part of a treatment regimen for cancer must be weighed against the potential risk of harm to the patient and in the pregnant patient, the risk to the developing fetus. Information necessary for determining the potential effects of RT on the developing fetus include the gestational age, absorbed fetal dose-equivalent, and dose-rate. The risk periods in humans for RT-induced prenatal or neonatal death, congenital anomalies, severe mental retardation (SMR), temporary (TGR) or permanent growth retardation (PGR), carcinogenesis, sterility, and germ cell mutations have been elicited directly from the study of Japanese victims of the atomic bombs and unintentional medical exposures, and indirectly from animal experiments. The wide range of congenital anomalies elicited from animal studies have not occurred in the Japanese atomic bomb victims exposed in utero. The major congenital anomaly observed in the Japanese cohort has been microcephaly. The highest risk period for SMR correlates with the proliferation, differentiation, and, most importantly, migration of neurons from their proliferative zones. PGR was apparent 17 years after ionizing radiation (IR) exposure at Hiroshima in children who were within 1,500 meters of the hypocenter. Children were on average 2.25 cm shorter, 3 kg lighter, and had head diameters 1.1 cm smaller than age-matched children. The projected lifetime risk of cancer mortality in the Japanese cohort is 14% per gray. The risk of a radiation-induced hereditary disorder is reported to be approximately 1% per gray. RT plays a major role in the definitive treatment of cervical and breast carcinomas, Hodgkin's disease, and non-Hodgkin's lymphoma. With appropriate abdominal shielding in place, the estimated fetal dose can be reduced by 50% or greater in most cases. In certain clinical situations, RT may be administered during pregnancy.
Progress in clinical and biological research, 1990
... Depletion of bone marrow T-lymphocytes with an anti-CD5 monoclonal immunotoxin (ST-1 immunoto... more ... Depletion of bone marrow T-lymphocytes with an anti-CD5 monoclonal immunotoxin (ST-1 immunotoxin): effective prophylaxis for graft-versus-host disease. Antin JH, Bierer BE, Smith BR, Guinan EC, Provost MM, Ferrara J, Macklis RM, Tarbell NJ, Blythman H, Bouloux C, et al. ...
Since the early decades of this century, radiation therapy has played an important role in the ma... more Since the early decades of this century, radiation therapy has played an important role in the management of Wilms' tumor. Although in prior years the high radiation doses and eccentric field arrangements used in treatment were responsible for significant late toxicity, examination of long-term survivors and the important information obtained from the National Wilms' Tumor Studies (NWTS) and Societe Internationale d'Oncologie Pediatrique studies have now allowed us to tailor radiation fields and doses to provide high levels of local tumor control with minimal late effects. At present, most patients with NWTS stage III and stage IV tumors are offered radiotherapy as an integral component of their cancer management. Attempts to further refine selection criteria defining those patient groups who will benefit from radiation therapy are ongoing.
International Journal of Radiation Oncology Biology Physics, Oct 1, 2003
This study was undertaken to determine whether radiation therapy (RT) delay of &a... more This study was undertaken to determine whether radiation therapy (RT) delay of >or=10 days had an adverse impact on abdominal tumor recurrence among children with favorable histology (FH) Wilms' tumor enrolled in National Wilms' Tumor Study (NWTS) 3 and 4. A total of 1226 patients with Stage II-IV FH tumors who received flank or abdominal RT in NWTS-3 and NWTS-4 were included in this analysis. Recurrent disease in the operative bed was classified as flank recurrence. Abdominal recurrence included all infradiaphragmatic tumor recurrences, including flank recurrences. This analysis included all flank/abdominal tumor recurrences, regardless of whether they might have been the initial or subsequent site of relapse. Based on the NWTS-1 results, RT delay was analyzed in two categories: 0-9 days and >or=10 days. The mean RT delay was 10.9 days; median delay was 9 days (range: 1-277 days). The RT delay was concentrated in a relatively narrow range of 8 to 12 days after nephrectomy in the majority of patients (59%). Univariate and multivariate analysis did not reveal RT delay of >or=10 days to significantly influence flank and abdominal tumor recurrence rates in NWTS-3 or NWTS-4. The 8-year flank tumor recurrence rates for 0-9 days and 10+ days RT delay were 1.9% and 1.2%, respectively (p value = 0.3). The 8-year abdominal tumor recurrence rates for 0-9 days and 10+ days RT delay were 4.8% and 5.3%, respectively (p value = 0.7). RT delay of…
What is the function of the cerebellum? Since the pioneering studies of Reil, Flourens, Magendie,... more What is the function of the cerebellum? Since the pioneering studies of Reil, Flourens, Magendie, BrownSequard, and their contemporaries,‘ neuroanatomic analyses have emphasized the overriding importance of the cerebellum and its efferent and afferent tracts in proprioception and the integration of purposeful movement. Yet, over the last two decades, a substantial body of knowledge has begun to suggest a more subtle role for the cerebellum in behavioral patterning and as a part of a cognitive regulatory network extending to the hippocampus, septum, amygdala, and the limbic system.2 This regulatory network may be capable of modifying various emotion-laden psychological processes such as sensory integration, aggression, and reproductive arousaL3-’l Some subjects suffering from diffuse psychopathologic states such as senile dementia and autism demonstrate significant abnormalities in cerebellar morphology and histoanatomy.“$) In autism, for example, some postmortem histopathologic and morphometric analyses have revealed gross hypoplasia within the cerebellar vermis, diffuse loss of Purkinje cells throughout the cerebellar hemispheres, and a 50% to 90% loss of Purkinje cells in the archicerebellum.x,9 While these data are controversial and apparently at odds with recent correlative MRI studies performed on autistic children, I n the reported histopathologic patterns are provocative and suggest that the cerebellum and its projections may be implicated in important nonmotor functions. The hypothesis that the cerebellum is involved in emotive processing and cognitive activities is not new.“ In fact, this supposition was at the center of an acrimonious dispute between the 19th-century phrenological movement and its skeptical detractors from the academic mainstream.” According to Franz Joseph Gall ( 1758-1828), t h e peripatetic Swiss neuroanatomist, psychologist, iconoclast, and international impresario who founded phrenology some two centuries ago,l2-l4 the motor functions of the cerebellum were entirely secondary. For Gall and his followers, the cerebellum was nothing less than the primary anatomic locus of love.’:’ To understand the basis of Gall’s conjecture, it is necessary to appreciate the intellectual context of the phrenologic movement.’:’ Born into an era that was heavily influenced by Rousseau and the neoclassic Naturphilosophie movement (which emphasized detailed comparative anatomy studies aimed at deciphering the hidden relationships between biological structure and function), Gall postulated the existence of an orderly neuronal hierarchy composed of a series of relatively autonomous intracerebral ganglia, each devoted to a certain type of thought process or activity and each capable of reciprocal reinforcement or inhibition through an interconnecting network (figure l).l:I The relative importance of each type of thought process in the overall psychologic make-up of the individual could be inferred, Gall claimed, by cranioscopic examin ation of the indentations in the skull overlying each of these neurologic loci. A well-trained phrenologist could thus pass judgment on the character of an unknown individual either anteor postmortem merely by taking certain key measurements of skull topography (figure 2). The cerebellum was considered the primary node in this hierarchy, and was considered the locus of sexual (“amative”) love, while the overlying occipital pole and cuneus was considered the locus of maternawpaternal love for one’s children and dependents (“philoprogenitive” love 1. The surface anatomy correlates of these centers are depicted in figure 3.
ABSTRACT Radithor was a radioactive patent medicine that was touted as a metabolic stimulant and ... more ABSTRACT Radithor was a radioactive patent medicine that was touted as a metabolic stimulant and aphrodisiac. We have obtained several original samples of Radithor and have used these historical specimens and a computer-based calculation model to perform a retrospective analysis of a famous case of Radithor-related radium poisoning. Our data suggest that the victim's cumulative skeletal radiation dose may have exceeded 350 Sv by the time he died. This figure far exceeds most current estimates of what radiation exposure level would constitute a rapidly lethal dose if given acutely. The physiological response to longterm internal radiation exposure and the highly localized nature of alpha particle irradiation may require the development of new models for the assessment of risk in cases of internal alpha particle irradiation.
"Radiation hormesis" is the name given to the putative stimulatory effects of low level ionizing ... more "Radiation hormesis" is the name given to the putative stimulatory effects of low level ionizing radiation (generally in the range of 1-50 cGy of low-LET radiation). Based on historical and pharmacologic principles reminiscent of some of the major tenets of homeopathy, most of these effects are now generally ascribed to protective feedback systems that, upon exposure to low concentrations of toxins, proceed to stimulate metabolic detoxification and repair networks. The activation of these networks may then result in net beneficial effects on the cell, organism or species. Discussions of possible stimulatory effects of low levels of ionizing radiation have recently become entangled with the separate but related question of whether a threshold dose level exists on the radiotoxicologic dose-response curve. This review summarizes some of the relevant historical and scientific data bearing on the question of radiation hormesis. We find the data in support of most of the hormesis postulates intriguing but inconclusive.
Written by medical students for medical students, this manual provides concise, rapidly digestibl... more Written by medical students for medical students, this manual provides concise, rapidly digestible information about those aspects of clinical medicine that cannot effectively be learnt in the classroom setting. The book includes: chapters on write-ups and presentations - these are two major sources of angst for medical students on their rotations that are usually not covered well in the ICM course, but learnt on the job; new drug appendix - to make it easier for students to get a quick handle on any drug they are likely to encounter; chapters on diagnostic tests (lab, X-ray, ECG) - succinct coverage of when and why to order them, and what to do with the results.
Cancer therapies based on administered radionuclides require accurate information on tumor dose. ... more Cancer therapies based on administered radionuclides require accurate information on tumor dose. One of the major factors influencing the distribution of absorbed-dose characteristics is the uniformity of the radiolabel distribution in tissue. To study the effect of nonuniformities, we used image analysis techniques to measure automatically the coordinates of autoradiographic grains (sources) and cell nuclei in cut sections from three different tumors, following treatment with radiolabeled antibodies. The spatial distribution data of sources and cell nuclei from these tumor sections were assessed and the pattern of energy deposition in the cell nuclei calculated, assuming that each autoradiograph grain corresponded to a source of the alpha emitter astatine-211 (211At) or the beta emitter yttrium-90 (90Y). The distribution of deposited energy obtained for the real grain distributions was compared to the distribution assuming a locally uniform source distribution, i.e., simulating grain count averaging as produced by a microdensitometric method within a 100 x 100 microns 2 frame size (frame averaging), and a uniform distribution across the entire section (section averaging). The results show first that when the grain distribution is uniform, the average dose within the section is an adequate estimate of the dose to the cell nuclei. Second, when the grain distribution is nonuniform, the distribution of doses to the cell nuclei is significantly less when calculations use the measured grain coordinates, or frame averaging, than when section averaging is used. Third, when the sources are located on or in the cells, both frame and section averaging produce underestimates of the dose to the cell nuclei.
Coincident lymphoma and pregnancy is rare, occurring in only one of 1,000 or fewer deliveries. Pa... more Coincident lymphoma and pregnancy is rare, occurring in only one of 1,000 or fewer deliveries. Patients with Hodgkin's disease usually present with typical manifestations, and most studies suggest that the disease probably has little or no effect on the pregnancy and vise versa. In contrast, patients with non-Hodgkin's lymphoma often have unusual manifestations and their diagnosis is frequently delayed. These patients usually have aggressive, advanced-stage disease and a poor outcome. The optimal management of these women requires special considerations. Treatment during the first trimester is associated with significant risk to the developing fetus and should be avoided. Women requiring treatment at this time should have a therapeutic abortion. Beyond the first trimester, the management options for women with Hodgkin's disease include observation until disease progression or delivery, single-agent vinblastine, modified or standard combination chemotherapy, and radiation therapy (with appropriate shielding). Because of their poor prognosis, women with non-Hodgkin's lymphoma should receive standard chemotherapy (despite the potential risk to the developing fetus).
International Journal of Radiation Oncology Biology Physics, Nov 1, 2006
ABSTRACT The aim of this study was to review advances in radioimmunotherapy (RIT) for non-Hodgkin... more ABSTRACT The aim of this study was to review advances in radioimmunotherapy (RIT) for non-Hodgkin's lymphoma (NHL) and to discuss the role of the radiation oncologist in administering this important new form of biologically targeted radiotherapy. A review of articles and abstracts on the clinical efficacy, safety, and radiation safety of yttrium Y 90 (90Y) ibritumomab tiuxetan (Zevalin) and iodine I 131 tositumomab (Bexxar) was performed. The clinical efficacy of RIT in NHL has been shown in numerous clinical trials of 90Y ibritumomab tiuxetan and 131I tositumomab. Both agents have produced significant responses in patients with low-grade, follicular, or transformed NHL, including patients with disease that had not responded or had responded poorly to previous chemotherapy or immunotherapy. Reversible toxicities such as neutropenia, thrombocytopenia, and anemia are the most common adverse events with both agents. Radioimmunotherapy is safe and effective in many patients with B-cell NHL. 90Y ibritumomab tiuxetan and 131I tositumomab can produce clinically meaningful and durable responses even in patients in whom chemotherapy has failed. Treatment with RIT requires a multispecialty approach and close communication between the radiation oncologist and other members of the treatment team. The radiation oncologist plays an important role in treating patients with RIT and monitoring them for responses and adverse events after treatment.
The benefits of radiation therapy (RT) as part of a treatment regimen for cancer must be weighed ... more The benefits of radiation therapy (RT) as part of a treatment regimen for cancer must be weighed against the potential risk of harm to the patient and in the pregnant patient, the risk to the developing fetus. Information necessary for determining the potential effects of RT on the developing fetus include the gestational age, absorbed fetal dose-equivalent, and dose-rate. The risk periods in humans for RT-induced prenatal or neonatal death, congenital anomalies, severe mental retardation (SMR), temporary (TGR) or permanent growth retardation (PGR), carcinogenesis, sterility, and germ cell mutations have been elicited directly from the study of Japanese victims of the atomic bombs and unintentional medical exposures, and indirectly from animal experiments. The wide range of congenital anomalies elicited from animal studies have not occurred in the Japanese atomic bomb victims exposed in utero. The major congenital anomaly observed in the Japanese cohort has been microcephaly. The highest risk period for SMR correlates with the proliferation, differentiation, and, most importantly, migration of neurons from their proliferative zones. PGR was apparent 17 years after ionizing radiation (IR) exposure at Hiroshima in children who were within 1,500 meters of the hypocenter. Children were on average 2.25 cm shorter, 3 kg lighter, and had head diameters 1.1 cm smaller than age-matched children. The projected lifetime risk of cancer mortality in the Japanese cohort is 14% per gray. The risk of a radiation-induced hereditary disorder is reported to be approximately 1% per gray. RT plays a major role in the definitive treatment of cervical and breast carcinomas, Hodgkin's disease, and non-Hodgkin's lymphoma. With appropriate abdominal shielding in place, the estimated fetal dose can be reduced by 50% or greater in most cases. In certain clinical situations, RT may be administered during pregnancy.
Progress in clinical and biological research, 1990
... Depletion of bone marrow T-lymphocytes with an anti-CD5 monoclonal immunotoxin (ST-1 immunoto... more ... Depletion of bone marrow T-lymphocytes with an anti-CD5 monoclonal immunotoxin (ST-1 immunotoxin): effective prophylaxis for graft-versus-host disease. Antin JH, Bierer BE, Smith BR, Guinan EC, Provost MM, Ferrara J, Macklis RM, Tarbell NJ, Blythman H, Bouloux C, et al. ...
Since the early decades of this century, radiation therapy has played an important role in the ma... more Since the early decades of this century, radiation therapy has played an important role in the management of Wilms' tumor. Although in prior years the high radiation doses and eccentric field arrangements used in treatment were responsible for significant late toxicity, examination of long-term survivors and the important information obtained from the National Wilms' Tumor Studies (NWTS) and Societe Internationale d'Oncologie Pediatrique studies have now allowed us to tailor radiation fields and doses to provide high levels of local tumor control with minimal late effects. At present, most patients with NWTS stage III and stage IV tumors are offered radiotherapy as an integral component of their cancer management. Attempts to further refine selection criteria defining those patient groups who will benefit from radiation therapy are ongoing.
International Journal of Radiation Oncology Biology Physics, Oct 1, 2003
This study was undertaken to determine whether radiation therapy (RT) delay of &a... more This study was undertaken to determine whether radiation therapy (RT) delay of >or=10 days had an adverse impact on abdominal tumor recurrence among children with favorable histology (FH) Wilms' tumor enrolled in National Wilms' Tumor Study (NWTS) 3 and 4. A total of 1226 patients with Stage II-IV FH tumors who received flank or abdominal RT in NWTS-3 and NWTS-4 were included in this analysis. Recurrent disease in the operative bed was classified as flank recurrence. Abdominal recurrence included all infradiaphragmatic tumor recurrences, including flank recurrences. This analysis included all flank/abdominal tumor recurrences, regardless of whether they might have been the initial or subsequent site of relapse. Based on the NWTS-1 results, RT delay was analyzed in two categories: 0-9 days and >or=10 days. The mean RT delay was 10.9 days; median delay was 9 days (range: 1-277 days). The RT delay was concentrated in a relatively narrow range of 8 to 12 days after nephrectomy in the majority of patients (59%). Univariate and multivariate analysis did not reveal RT delay of >or=10 days to significantly influence flank and abdominal tumor recurrence rates in NWTS-3 or NWTS-4. The 8-year flank tumor recurrence rates for 0-9 days and 10+ days RT delay were 1.9% and 1.2%, respectively (p value = 0.3). The 8-year abdominal tumor recurrence rates for 0-9 days and 10+ days RT delay were 4.8% and 5.3%, respectively (p value = 0.7). RT delay of…
What is the function of the cerebellum? Since the pioneering studies of Reil, Flourens, Magendie,... more What is the function of the cerebellum? Since the pioneering studies of Reil, Flourens, Magendie, BrownSequard, and their contemporaries,‘ neuroanatomic analyses have emphasized the overriding importance of the cerebellum and its efferent and afferent tracts in proprioception and the integration of purposeful movement. Yet, over the last two decades, a substantial body of knowledge has begun to suggest a more subtle role for the cerebellum in behavioral patterning and as a part of a cognitive regulatory network extending to the hippocampus, septum, amygdala, and the limbic system.2 This regulatory network may be capable of modifying various emotion-laden psychological processes such as sensory integration, aggression, and reproductive arousaL3-’l Some subjects suffering from diffuse psychopathologic states such as senile dementia and autism demonstrate significant abnormalities in cerebellar morphology and histoanatomy.“$) In autism, for example, some postmortem histopathologic and morphometric analyses have revealed gross hypoplasia within the cerebellar vermis, diffuse loss of Purkinje cells throughout the cerebellar hemispheres, and a 50% to 90% loss of Purkinje cells in the archicerebellum.x,9 While these data are controversial and apparently at odds with recent correlative MRI studies performed on autistic children, I n the reported histopathologic patterns are provocative and suggest that the cerebellum and its projections may be implicated in important nonmotor functions. The hypothesis that the cerebellum is involved in emotive processing and cognitive activities is not new.“ In fact, this supposition was at the center of an acrimonious dispute between the 19th-century phrenological movement and its skeptical detractors from the academic mainstream.” According to Franz Joseph Gall ( 1758-1828), t h e peripatetic Swiss neuroanatomist, psychologist, iconoclast, and international impresario who founded phrenology some two centuries ago,l2-l4 the motor functions of the cerebellum were entirely secondary. For Gall and his followers, the cerebellum was nothing less than the primary anatomic locus of love.’:’ To understand the basis of Gall’s conjecture, it is necessary to appreciate the intellectual context of the phrenologic movement.’:’ Born into an era that was heavily influenced by Rousseau and the neoclassic Naturphilosophie movement (which emphasized detailed comparative anatomy studies aimed at deciphering the hidden relationships between biological structure and function), Gall postulated the existence of an orderly neuronal hierarchy composed of a series of relatively autonomous intracerebral ganglia, each devoted to a certain type of thought process or activity and each capable of reciprocal reinforcement or inhibition through an interconnecting network (figure l).l:I The relative importance of each type of thought process in the overall psychologic make-up of the individual could be inferred, Gall claimed, by cranioscopic examin ation of the indentations in the skull overlying each of these neurologic loci. A well-trained phrenologist could thus pass judgment on the character of an unknown individual either anteor postmortem merely by taking certain key measurements of skull topography (figure 2). The cerebellum was considered the primary node in this hierarchy, and was considered the locus of sexual (“amative”) love, while the overlying occipital pole and cuneus was considered the locus of maternawpaternal love for one’s children and dependents (“philoprogenitive” love 1. The surface anatomy correlates of these centers are depicted in figure 3.
ABSTRACT Radithor was a radioactive patent medicine that was touted as a metabolic stimulant and ... more ABSTRACT Radithor was a radioactive patent medicine that was touted as a metabolic stimulant and aphrodisiac. We have obtained several original samples of Radithor and have used these historical specimens and a computer-based calculation model to perform a retrospective analysis of a famous case of Radithor-related radium poisoning. Our data suggest that the victim's cumulative skeletal radiation dose may have exceeded 350 Sv by the time he died. This figure far exceeds most current estimates of what radiation exposure level would constitute a rapidly lethal dose if given acutely. The physiological response to longterm internal radiation exposure and the highly localized nature of alpha particle irradiation may require the development of new models for the assessment of risk in cases of internal alpha particle irradiation.
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Papers by Roger M Macklis