Muller’s phlebectomy

SummaryMore than 50 years ago, the Swiss dermatologist Dr Robert Muller developed ambulatory phlebectomy, a brilliant demonstration of the major role of dermatologists in the field of phlebology. The technique is safe, reliable and cost-effective, while at the same time producing aesthetically pleasing results. Patients can usually resume normal daily activities immediately after the procedure or are off work for a few days at most. Indications for ambulatory phlebectomy include incompetent saphenous veins (except the junctions) and their tributaries, perforators, reticular veins and reticular feeder veins, large spider veins and dilated veins in other areas such as around the eyes, on the arms or on the back of the hands.The tiny skin incisions do not usually leave any scars or give rise to complications. Phlebectomy can be used alone or in combination with other procedures such as sclerotherapy, endovenous techniques and surgery.

Emotions Are Not Modules1

Jane is calmly strolling through the forest one lovely day. Suddenly, a large spider drops in front of her face. She immediately freezes; her heart races; her hands tremble; her face broadcasts “fear.” She screams and runs away. Both before and after, she concedes that spiders in this forest are harmless.Jane's reaction to the spider contrasts greatly with the way she normally reacts to events. Normally, or so the story goes, Jane weighs her options thoughtfully, choosing a course of action consistent with her beliefs and with the greatest benefit. Indeed, her reaction to the spider contrasts so greatly with calm, rational, deliberate, belief-consistent action that traditional folk psychology supposed two different kinds of mechanism are at work: animal-like emotion (located in the heart and gut) versus human reason (located in the mind). Her emotion explains her reaction to the spider. Her emotion made her do it.

Encephalitis periaxialis diffusa

This is the name of the disease, the first 2 cases of which were described by Schieder in 1912-1913. Macroscopically with it, according to Graf (Arch. F. Psych .. Bd. 73), a limited focus is found in the brain of the hemispheres, and histologically - the disintegration of the pulp with the relative intactness of the axial cylinders, rich development of granular and large spider-like cells, increased neuroglia and vascular infiltrates.

Changes in the Cerebellar Neuroglia in Progressive Paralysis [Die Gliaveränderungen im Kleinhirn bei den progressiven Paralyse]. (Arch. f. Psychiat. u. Nervenkr., B. xxxiv, H. 2, p. 523.) Raecke, Dr

Fifteen cases in which the changes in the cerebellar neuroglia were specially studied are given in some detail. The results correspond generally to those of Weigert. In the molecular layer, Bergman's fibres are increased in numbers, but unevenly. Most of the new fibres run vertically, but some obliquely or transversely, the last often forming bands at two levels, viz. along the outer margin of the cortex and at the boundary of the granular layer. In the latter position they form basketworks enclosing Purkinje's cells. The transverse fibres are mostly delicate, but a number of large spider-cells at the border of the granule layer give off coarse fibres, running to the surface. The largest collection of glia-nuclei is in the same situation. In the granule layer also the changes are of unequal degree. They consist in loss of granules, the place of which is taken by hypertrophied neuroglia fibre and nuclei. In the medulla the hypertrophy is rarely of great extent, and appears to prefer the immediate neighbourhood of the vessels, where large, coarse-fibred spider-cells are also found. Fibres and nests of glia-nuclei occur, however, between the nerve-bundles. Jn general, the rule is that in progressive paralysis the molecular layer is most involved, then the granule layer, more in spots, and last and least the medulla. Hence it is the dendrites of Purkinje's cells which appear to be chiefly affected in this disease, and their bodies also vanish in advanced cases. The morbid process thus seems to advance from without inwards. Little clinical value is claimed for these results, owing to the irregular distribution and frequently slight degree of the foci of disease; but it may be supposed that the changes contribute to the ataxy and incoordination. The paralytic seizures are more likely, from these cases, to be connected with diseased foci in the thalamus. No relation could be detected between the cerebellar changes and absence or increase of the reflexes.

XVI. A supposition how the white matter is produced, which floats about in the air in autumn; in a letter from the same to Mr. Baker

Sir, Having lately a large Spider in my Hand, by chance I let it fall, and it hung by its Thread, as they very commonly do.