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The cyanobacterium Spirulina is a popular generic proventil 100mcg without a prescription asthmatic bronchitis 4 times, high fresh antiserum was used order 100 mcg proventil asthma treatmentvaporizer. Finding that he could restore the bacteriolytic power of See also Fossilization of bacteria; Photosynthetic microorgan- the antiserum if he added a little fresh serum from a non- isms immunized animal, Bordet concluded that the bacteria-killing phenomenon was due to the combined action of two distinct substances: an antibody in the antiserum, which specifically BORDATELLA PERTUSSIS • see PERTUSSIS acted against a particular kind of bacterium; and a non-spe- cific substance, sensitive to heat, found in all animal serums, which Bordet called “alexine” (later named “complement”). In a series of experiments conducted later, Bordet also BBordet, JulesORDET, JULES (1870-1961) learned that injecting red blood cells from one animal species Belgian physician (rabbit cells in the initial experiments) into another species (guinea pigs) caused the serum of the second species to Jules Bordet’s pioneering research made clear the exact man- quickly destroy the red cells of the first. And although the ner by which serums and antiserums act to destroy bacteria serum lost its power to kill the red cells when heated to 55 and foreign blood cells in the body, thus explaining how degrees centigrade, its potency was restored when alexine (or human and animal bodies defend themselves against the inva- complement) was added. Bordet was also responsible for hemolytic (red cell destroying) serums acted exactly as bacte- developing complement fixation tests, which made possible riolytic serums; thus, he had uncovered the basic mechanism the early detection of many disease-causing bacteria in human by which animal bodies defend or immunize themselves and animal blood. For his various discoveries in the field of against the invasion of foreign elements. Eventually, Bordet immunology, Bordet was awarded the Nobel Prize for medi- and his colleagues found a way to implement their discover- cine or physiology in 1919. They determined that alexine was bound or fixed to red Jules Jean Baptiste Vincent Bordet was born in blood cells or to bacteria during the immunizing process. Soignies, Belgium, a small town situated twenty-three miles When red cells were added to a normal serum mixed with a southwest of Brussels. He was the second son of Charles specific form of bacteria in a test tube, the bacteria remained Bordet, a schoolteacher, and Célestine Vandenabeele Bordet. However, when serum containing the antibody spe- received an appointment to the École Moyenne, a primary cific to the bacteria was destroyed, the alexine and the solution school. Jules and his older brother Charles attended this school separated into a layer of clear serum overlaying the intact red and then received their secondary education at the Athéné cells. Hence, it was possible to visually determine the pres- Royal of Brussels. It was at this time that Bordet became ence of bacteria in a patient’s blood serum. This process interested in chemistry and began working in a small labora- became known as a complement fixation test. He entered the medical pro- associates applied these findings to various other infections, gram at the Free University of Brussels at the age of sixteen, like typhoid fever, carbuncle, and hog cholera. Bordet began his Wasserman eventually used a form of the test (later known as research career while still in medical school, and in 1892 pub- the Wasserman test) to determine the presence of syphilis bac- lished a paper on the adaptation of viruses to vaccinated teria in the human blood. For Already famous by the age of thirty-one, Bordet this work, the Belgian government awarded him a scholarship accepted the directorship of the newly created Anti-rabies and to the Pasteur Institute, and from 1894 to 1901, Bordet stayed Bacteriological Institute in Brussels in 1901; two years later, in Paris at the laboratory of the Ukrainian-born scientist Élie the organization was renamed the Pasteur Institute of Brussels. In 1899, Bordet married Marthe Levoz; they From 1901, Bordet was obliged to divide his time between his eventually had two daughters, and a son who also became a research and the administration of the Institute. Soon after his arrival at the Institute, he began work other activities, he continued his research in immunology and on a problem in immunology. In 1906, Bordet and Octave Gengou succeeded 83 Borel, Jean-François WORLD OF MICROBIOLOGY AND IMMUNOLOGY in isolating the bacillus that causes pertussis (whooping isolated compound selectively suppressed the T cells of the cough) in children and later developed a vaccine against the immune system. By the end of that decade, Borel had demonstrated the studies on the coagulation of blood. The Traité de l’immunité dans les maladies infectieuses (1920), a compound was found to be insoluble. He was in the United some of the compound in alcohol (subsequently, the use of States to raise money for new medical facilities for the war- olive oil as an emulsifier proved more efficient) and drank it, damaged Free University of Brussels when he received word the compound subsequently appeared in his blood. After 1920, he major finding, indicating that the compound might be became interested in bacteriophage, the family of viruses that amenable to injection so as to control the immune rejection of kill many types of bacteria, publishing several articles on the transplanted organs. In 1940, Bordet retired from the directorship of the There has been a controversy as to whether Borel or Pasteur Institute of Brussels and was succeeded by his son, another Sandoz scientist (Harold Stähelin) was primarily Paul. Bordet himself continued to take an active interest in the responsible for the discovery of cyclosporin. Both were work of the Institute despite his failing eyesight and a second actively involved at various stages in the purification and test- German occupation of Belgium during World War II. Many ing of the compound, and the primary contribution is difficult scientists, friends, and former students gathered in a celebra- to assign. Nonetheless, it was Borel who first established the tion of his eightieth birthday at the great hall of the Free immunosuppressant effect of cyclosporin, during routine test- University of Brussels in 1950.

Within three months of start- ing school 100mcg proventil for sale asthma symptoms in adults cough, she suddenly developed problems buy 100 mcg proventil overnight delivery asthma treatment ventilator. Even though by being in school with other children she had more stimulation than ever before, she seemed less inquisitive or interested in things than she had been. Slowly she stopped learning new words, her vocabulary became limited, and she seemed listless. Lourdes stopped listening to her parents and teacher and even refused to look at the person speaking to her. When Lourdes wasn’t being difficult, she seemed to withdraw into herself. Lour- des’s mother immediately took her to the pediatrician who, after listening to her symptoms, reassured Elise that some children were just “wired that way. Not only did Lourdes not grow out of it, she became progressively worse over the next three months. First, not feeling confident that her pedi- atrician was right in disregarding the teacher’s suggestion that Lourdes might be autistic, Elise logged onto the Internet. It became clear that her daughter did not have any of the significant symptoms or signs that one would expect with autism. Fortunately, Elise had heard about the Eight Steps to Self-Diagnosis from a friend, and before she began putting her child through all kinds of medical testing, she decided to work through them. In returning several times to Step Two, relating to the history of Lourdes’s symptoms, she real- ized that her daughter had started exhibiting all her symptoms soon after she had caught a bad cold from the children at school. Then in considering Step Three relative to what made her daughter’s symptoms worse, she noted that Lourdes was especially resistant and inat- tentive when they were driving in the car, with the little girl in the back in a child’s car seat. Lourdes seemed best when her mother had her attention and was having a direct conversation with her. In other words, Elise had to have a face-to-face interaction to get her daughter’s attention. Instead of returning to the pediatrician, Elise took her daughter to an audiologist, who discovered that Lourdes had a significant hearing loss. This 198 Diagnosing Your Mystery Malady explained a lot, such as why she wasn’t “listening” to the teacher or her par- ents and seemed inattentive, as well as why her vocabulary wasn’t expand- ing in either Spanish or English. Lourdes was worse in the backseat of the car because she couldn’t read her mother’s lips, whereas when she was engaged in direct eye contact and conversation, she became communicative again. Since these symptoms started when Lourdes became sick, Elise took her daughter to an ear, nose, and throat doctor. He found that both of her middle ears were full of fluid—the remnants of the cold that Lourdes caught after beginning nursery school. Once they placed drain tubes in Lourdes’s eardrums (tympanic mem- branes), her hearing improved dramatically. Her vocabulary caught up to her age level, and Lourdes returned to being the bright, inquisitive, and well- behaved child she once was. Without solid research on the Internet and a step-by-step analysis, Lourdes’s mother would not have been able to get the help her daughter needed as quickly as she did. Case Study: Justin Justin was a nine-year-old who had just earned his first badge as a Cub Scout. After he attended scout camp that summer and achieved his second badge, he informed his parents he intended to work toward becoming an Eagle Scout. His parents were pleased and hoped his five-year-old brother would follow in his footsteps. One morning, Justin’s brother told his parents that Justin was not sleeping and was walking around the house during the night. Justin’s folks began to worry that there was something going on at school that their son was not talking about. When they confronted him, he denied anything unusual was happening there. One day Justin began to complain that he had tingling in his hands and feet. Sometimes he wet his pants, and other times he went for long periods without urinating at all.

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Constituent Parts buy proventil 100 mcg asthma treatment quick, and Internal Structure of the Hands being put in nomination for reading of the Bones”; October 30 and November 13 cheap proventil 100 mcg on line asthma symptoms medication, 1689, same. Havers was chosen for three years to “The second Discourse of Accretion and Nutri- read on the second Tuesday, Wednesday and tion”; January 29, 1689, “The third Discourse of Thursday in July next by three of the clock in the the Marrow”; November 20 and 27, 1689, “The afternoon and to have thirty shillings for his pains fourth Discourse of the Mucilaginous Glands”; and the remainder to be disposed of by the Com- August 13, 1690, “The fifth Discourse of the Car- mitte. John Gale, who left an annuity of book in 1691, under the title Osteologia nova, or £16 to the Company of Barbers and Surgeons for some Few Observations of the Bones, and the this purpose, and as the records do not show the Parts belonging to them, with the manner of their appointment of any previous lecturer, Dr. The records do Richard Morton, in which he makes the follow- not reveal how they disposed of the rest of the 131 Who’s Who in Orthopedics money. Tyson” (who from the register in Willingale Church, the writer had recently retired). Howell: “Clopton Havers, MD, was buried April This is entitled “A short Discourse concerning 29th, 1702, in what was made of sheep’s wool Concoction” and it appeared in the Philosophical only and affidavit thereof made and delivered the Transactions of the Royal Society in 1699 (vol. Possibly too much of his time accordance with a law passed in 1666 in the inter- was occupied in the exercise of his profession to ests of the wool trade, and the following is an permit any further great literary efforts after the extract from the Act: writing of his book in 1691, but certainly no facts are available to fill in the gap between this date For the encouragement of the woollen manufacture of and 1698. In 1702 was published a new edition of the kingdom, no person shall bee buried in anny shirt, Spaher and Remmelin’s, A Survey of the Micro- shrewd or sheet made of wool mingled with flax, hemp, cosme, or the Anatomy of the Bodies of Man and silk, hairs, gold or silver or any other than what shall Woman, edited and corrected by Havers. This be made of wool only or be putt into anny coffin lined must have been his last work, for in April 1702 or faced with anything made or mingled with flax, hemp etc. He was buried at Willingdale Doe in parish when such person shall be buried. Essex, in the grave of Thomas Fuller, a former rector of the parish, whose daughter he married. From In the same grave are the bodies of six of his chil- the same parish records comes the information dren, none of whom lived more than 3 years. The that Mary, the daughter of Dorcas Havers, the following extracts from Lilly Butler’s funeral widow, was buried at the same church on May 6, sermon give some estimation of his character: 1702, only a week after her father’s interment. He was a most respectful, dutiful son to his aged Father, Another entry records the burial of a Clopton frequent and liberal in making his acknowledgments to Havers, presumably the doctor’s son, on Novem- him for his ingenuous and chargeable Education, and ber 7, 1709. Having engaged himself in an honourable and Improvement in this last Age than Physick, so no part useful Calling, he faithfully pursued the Designs of it, of that has been more tempting, or more successfully as one who remembered the account he must give to pursued than Anatomy. The Dissections of many pre- the Maker of those Bodies he had undertaken the care ceding Ages turn’d to a small account; so that many of of, and truly Watched for their Lives. He took a great the most admirable Contrivances of Nature and of the deal of Pains to improve himself in that Knowledge greatest Wonders in the lesser World, were inobserv’d; which was necessary to qualify him for a laudable till the Curiosity of some ingenious Men, animated discharge of so great a Trust.... His Countenance with the hopes of some new Discoveries, put them upon was grave and serious, without any lines of Sorrowness farther Enquiries; in which their Industry and Felicity or Affectation; his Speech was soft and obliging, carried them so far, that the Existence of some parts without any Air of conceit or Flattery; his Behaviour before unknown, the Nature, Structure and Use of gentile and courteous, without any Appearance of Art others, began to appear. Observations of our Age about some of the Parts have been very accurate, we have been only coasting about Dr. Luke and said that others; particularly about the internal Fabrick, and “he was not only esteemed by his Patients for his some other things of the Bones our Searchers have been great abilities and care and diligence, but exceed- careless, our Notice slight and transient: not but that ingly beloved too for his amiable Temper, his they deserve our strictest Enquiry and serious Remarks; obliging Tenderness and his most winning and for I do not see but the Almighty Architect has equally excellent Virtues. And how curious the Hand of his ingenious theory that the “porosity” decreased Heaven has been in the Framing and Ordering of this from the cavity towards the outside of the bone Timber-work of our Bodies, may perhaps appear a little because the amount of lubricating medullary oil from this Discourse. It seems very likely that Anthony van The particular concern of the present paper is to Leeuwenhoek, the pioneer microscopist, had give the original description of the “canals,” already observed these “canals” in bone, for in his which is to be found on page 43 of the English letter published in the Philosophical Transactions editions and on page 47 of the Latin edition pub- of the Royal Society on September 21, 1674, he lished in Amsterdam in 1731: makes the following statement: “I have several times endeavoured to observe the parts of a Bone, In the Bones, thro’ and between the Plates, are formed and at first I imagin’d, I saw on the surface of the Pores, besides those which are made for the Passage of Shinbone of a Cow several small veins (which the Blood-Vessels, which are of two sorts; some pene- bone I still keep by me); but I have not found trate the Laminae, and are transverse, looking from the it since in any other bone”... And that I may not be thought to pretend makes no other comment on this observation and to the discovery of what no other mens Eyes can so it must remain doubtful whether the structures discern, because they are generally very difficult to be he saw were actually those that later became observ’d, unless it be the transverse Pores in the inter- nal Lamell, I have the pieces of two Bones, which I known as Haversian canals. Havers was no copyist and he rightly not arranged in any kind of pattern, but have a named his work as Osteologia nova. That his “seeming irregularity,” which tends to preserve canals contained blood vessels and not merely the necessary strength of the bone tissue. The lon- medullary oil as he contended and that they had gitudinal pores are more difficult to see, but are probably been known previously to Leeuwenhoek best observed in the ribs. Havers assumed that the does not detract from the merits or the originality use of these pores was solely for the diffusion of of his observations at a time when the dissemina- the “Medullary Oil” for, he says: “About these tion of scientific knowledge was of necessity passages I was particularly strict in my enquiry, restricted. Nor must we minimize the importance whether they were not formed for Blood-Vessels, of his discovery of the penetrating periosteal tending either to or from the Marrow: and fibers afterwards known as Sharpey’s fibers although some of the Medullary Veins have Pores, (1848). These fibers he describes as “fibrillae or by which they penetrate into the substance of the threads,” and that he appears at times to regard Bone, yet I made my self certain, that these Pores, them as being nervous in function is probably due for the generality of them which I examined, had more to his usage of the term “nerve” in its orig- no Vessels which passed into them. That Portal13 course, Havers has since proved to be wrong, for 133 Who’s Who in Orthopedics should rather grudgingly recognize the originality Butler L (1741) The Character of Clopton Havers, of Havers and that he should stress his incomplete M. Memorials and Characters, acquaintance with contemporary literature must Together with Lives of Divers Eminent and Worthy Persons, 279. London not be taken in disparagement of the work of a Dictionnaire des Sciences Mi’dicales (1822) Biogra- man who, while in the active practice of his pro- phie Medicale 5:102.

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