3011767 ปฎิบัติการตรวจวินิจฉัยทางเวชศาสตร์นิวเคลียร์ขั้นสูงด้วยวิธีถ่ายภาพ Advanced Practical Nuclear Medicine Imaging
วิธีการตรวจ การวิเคราะห์ข้อมูล การแปลผล ลักษณะผิดปกติจากการตรวจอวัยวะของระบบต่าง ๆ ของร่างกาย ด้วยวิธีการถ่ายภาพทางเวชศาสตร์นิวเคลียร์ขั้นสูง
(Real-life prctice on procedures, data analysis, interpretation, abnormal findings from advanced radionuclide imagine study of all systems of the body.)
(3011767 จุฬาลงกรณ์มหาวิทยาลัย)
I was listening to Jan Morris on the Radio4’s Excess Baggage the other day. Actually I was listening to the podcast of Excess Baggage. I am a child of web 2.0 you know. Well a teenager really.
Anyway, as I said I was listening to this podcast on my iPodlet. And I was struck my two things, once is how very cool it is for Jan Morris to be able to talk on the radio and not be referred to as ‘Jan, formerly James’ Morris. The first 20 or so times I saw Jan Morris on TV she was referred to as Jan, formerly James Morris. The think I love about Jan Morris is that there is so much more to her writing than being a transsexual, and I find her descriptions haunting and evocative. I love reading them.
The other thing I noticed about Jan Morris on the Radio was that her disembodied voice did sound, er, male. Even however many years post transition. Now I am aware that my voice sounds female because occasionally people assume that I’m female on the phone.
In person very few people assume that I’m trans, because I look male the voice goes almost unnoticed. Though I do wonder if my secretary notices. She hears my disembodied voice every time I do a tape of letters from clinic. I have tried to avoid it. I can type nearly as fast as she can, so it seems silly to have to dictate letters. But I can’t print the letters of and file them in the right places, so I give in and dictate them.
But I can’t help wondering if my voice gives me away. Maybe she knows. Maybe the girls in the typing pool know. Maybe I should just insist on doing my own typing. It’s ridiculous to dictate when I can type at 70wpm. Though I don’t have a login for the automatic send a letter to GPs system the secretaries use.
From the better-late-than-never department: I’ve been getting questions in real life about how I view the new mammogram guidelines, so I might as well weigh in on them here, too.
First, the new guidelines are only the culmination of years of research that has demolished the belief that routine mammograms for women in their forties will save lives. I’ve been following the medical debates on early detection of breast cancer ever since a Danish metastudy called into question the efficacy of routine screening mammography back in 2001; Gina Kolata reported on this study for the New York Times, and she’s done a fabulous job of following the controversy ever since. Feminist advocacy groups, such as the National Breast Cancer Coalition, have long questioned the advisability of regular mammograms for women under 50. Basically, mammograms pick up a lot of false positives and miss a lot of actual tumors. They also result in treatment of cancers that may never become dangerous. For breast cancer (unlike, say, colon cancer), early detection is no panacea because cancer cells often metastasize very early on. The scientific evidence really is pretty compelling. I’m not going to dissect it here, but see Our Bodies, Our Blogs and Echidne as well as the very thorough analysis by the NBCC.)
Instead, I’m going to tease apart some myths and misconceptions that have muddied the debate. Most are coming from those who’ve criticized the new guidelines. (And no, I’m not even going to bother with Rushbo’s revival of the death panel canard; Echidne snarked it into oblivion already.)
First, the new guidelines have been accused of being racist, as in this post at Feministing. Note, though, that the guidelines in no way discourage routine screening of women who are at higher than average risk; instead, they propose evaluating each woman’s particular risk. Compared to other ethnic groups, black women are indeed at higher risk of developing breast cancer in their forties. The new guidelines are thus simply inapplicable to black women, since they only address women who are at low risk. Black women should definitely get routine screening earlier than white women. By now physicians should be aware that breast cancer discriminates by race; to the extent that they’re still clueless, what’s needed is better awareness through continuing medical education. The new guidelines call for individualized risk assessment, not cookie-cutter methods. If this doesn’t work for women of color – and I agree there’s a chance that it won’t – then the problem isn’t the new guidelines, it’s racism, ignorance, and medicine geared to the bottom line.
Second, the media is teeming with heart-rending stories about women who find a lump and who wouldn’t have gotten diagnosed under the new guidelines. While stories about the human costs of cancer are really important, these stories are completely irrelevant to the debate. If you find a lump, your doctor will send you for a diagnostic mammogram. The new guidelines only address screening mammograms, which are done at regular intervals without any reason to suspect cancer. The new guidelines say nothing about diagnostic mammograms, which have never been controversial.
Third, the new guidelines don’t have any binding power. I do think it’s reasonable to worry that insurers will refuse to cover mammograms for women under 50, just because insurers are always looking for ways to cut costs. That would be a gross misapplication of the guidelines, which call for women and their doctors to decide whether screening mammograms are right for them. I’m fairly sanguine about this, though, because the breast cancer lobby is strong enough – and the public outcry loud enough – that insurers are far more likely to cut corners elsewhere.
Fourth, there’s no evidence that the revised guidelines are motivated by sexism. Routine PSA screening for men has recently been challenged on very similar grounds. While prostate cancer survivors have been just as skeptical as breast cancer survivors when it comes to decreasing early detection efforts, they haven’t enjoyed a similar bully pulpit. Nor have men in general risen up in protest. Perhaps Sir Charles of Cogitamus is right when he suggests a link to men’s general tendency to use fewer medical services:
Not to engage in gender essentialism, but I think this may have to do with the fact that men are always comfortable with a recommendation that reinforces our tendency toward denial in these kinds of matters — oh the test is no good — great, I’ll skip it. (Or maybe I’m just projecting.)
At any rate, men and women face similar issues here, not fundamentally different ones. The conversation about what we gain and lose through massive screening campaigns is one that both men and women ought to be having.
Proponents of the new guidelines (including Echidne, whom I otherwise agree with) are also making one wobbly assumption: that funds not spent on screening mammograms will be redirected to areas where we’ll get more health for the buck. I’m skeptical. Insurance coverage of mammograms has been mandated by law. If those laws should change (and I’d be surprised if they did), insurance companies would more likely divert the funding for mammograms straight to their bottom line (see point three above). Sober policy analysis of costs and benefits needs to take good old fashioned greed into account, too.
So by all means, let’s have a debate about the limits and possibilities of early detection and huge screening campaigns. But let’s have it on the basis of facts, rather than using the new guidelines as a Rorschach blot for our hopes and fears. (I have more to say about those fears, but that’ll have to wait for another day.)
I drank an entire pot of soup yesterday before I left for the show, and thank goodness I did. My voice was mostly back for the duration of the show.
When I woke up this morning… or should I say afternoon? I didn’t wake up till 3. XD Anyways, when I woke up, my voice was completely gone. Yep. I’ve lost my voice. T_T But it’s okay, because I don’t need to be onstage for another two whole weeks! (Christmas concert)
So Music Man is over. Wow. It’s going to be weird going back to “real life”.
Now, time to get started on homework… T_T
My face hurts.
On a side note, last night I did something very shocking.
I can’t say I never expected to, since I’ve been pondering it for a while… but I guess I was on a sugar-high from Chelsea’s brownies or something. So I did it. O_O Oh my… Boldness isn’t always a good thing. I’m a little worried about how this might go. T_T
For over 25 years, I taught biofeedback, meditation and stress reduction for people suffering from chronic and debilitating psychological. He "has been extremely rewarding to be part of the magic of the human body itself is the repair process.
Satisfaction is only surpassed by the pleasure that I designed to engage the intelligence of my patients to help them embrace the removal of their health and mending process … serving more as a coach to call a discipline asregular as breathing … a little "all psychological processes opening attracts attention.
Organic long-and short-behavioral medicine is what was then called. You may know as "holistic healing" or "mind-body". It has several names.
I developed, managed and provided treatment to professional practice in serving the Chicago metropolitan area. When I look back, I am well aware of today is like teaching and healing nuggets of this book fills the desires of those currentlyattracted me to the service.
Why biofeedback and meditation for the victims of domestic violence
Over the past seven years I have dedicated my life to help survivors of domestic violence. My energy was consumed by the rubble of legal advocacy and social chaos of political violence. I realized that not wants not only, and may serve victims of domestic violence in bio-behavioral medicine, but I have to serve this population in this way.Why.
Biofeedback, meditation and training to reduce the stress associated with psychotherapy will help you find the "you" behind the rumors … The "you" back and front of your domestic violence … the "you" is the center of your being, if all goes well … when you are together, happy, at peace with yourself and the universe.
I stumbled upon this topic after reading this article (Kerala man fears ant could kill him)
Khader had emigrated to the Gulf and was doing good till 1998 when he took ill after an ant bite. His body was inflamed and he felt like he was in an oven. What surprised me the most is that doctors say that there is no permanent cure. The only solution is to keep out of the reach of ants. Man!
The condition is known as Anaphylactic Shock. It is quite serious and life-threatening.
According to Science Daily
Anaphylactic shock is an acute, life-threatening allergic reaction, usually brought on by medication, insect stings, or other allergens, which has become more frequent in recent decades. In sensitized persons, the presence of the allergen leads to the release of various substances (mediators) from immune cells in the blood.
Anaphylaxis can occur in response to any allergen. Common triggers include insect bites or stings, food allergies, and drug allergies. Pollens and other inhaled allergens rarely cause anaphylaxis.
Symptoms include constriction of the airways, resulting in wheezing, difficulty breathing, and gastrointestinal symptoms such as abdominal pain, cramps, vomiting, and diarrhea. Histamine causes the blood vessels to dilate (which lowers blood pressure) and fluid to leak from the bloodstream into the tissues (which lowers the blood volume). These effects result in shock.
First aid measures for anaphylaxis include rescue breathing (part of CPR). Rescue breathing may be hindered by the constricted airways, but if the patient stops breathing on his or her own, it is the only way to get oxygen to him or her until professional help is available.
Some patients with severe allergies routinely carry preloaded syringes containing epinephrine, diphenhydramine (Benadryl), and dexamethasone (Decadron) whenever they go to an unknown or uncontrolled environment. Some immunization that!
Read this
And she’s there, sitting inside the golden ratio as beautiful as ever. Me? I am on a parabola with no ends at all four corners. My destination is infinite and if I must get what I want then off this path I am to stride. But what is there isn’t sure of anything about herself right now and this is just an example of my helping hand and thirst for personal connection; an impact, a memory, a kiss.
And then there is the thought of distraction. Are the one’s in which I am meeting right now just pure distraction, something for me to chase after? And if the time were to come where a decision was necessary, no, needed, would I be the one to wave the flag and walk away? Am I a whore? Are my words too much for myself? I believe so because I am completely reading a blank and running amok in this cubicle of independence. Though being successful is all I ask, and no relations are wanted on an official level, the advancement on the company of said person would be highly appreciated.
Consider this the closest my heart can get to writing a love letter right now, girl. I don’t do it often. And I hate being blunt. But so be it; your energy, though you claim you lack it, is there and your smile; gorgeous. Yeah, I talk to other girls and tell them things but soon after, I only wish I was telling them to you. I am here, you can call me yours if you want…we don’t need the physical contact, just emotional connection, smirks and winks. I want to see those perfect teeth smiling back at me and then feel that beautiful head of hair upon my shoulder, maybe your hand in mine. That’s all.
And if this day comes, know I hope to never abandon you but I do have personal plans that will go through. Though miles apart, you’ll forever be beside me and the care we share wouldn’t wither and die like the false ideals of love. This is a growing experience and a personal bridge to my heart whenever you want to skip the traffic and come straight home.
….I can’t believe I just wrote this crap…but I guess I needed to let it out.
When I was a youngster, the doctor still was G-d. He (and it was almost always a he) was the expert and you knew nothing. That was especially true ’cause the “you” were usually females (macho men almost never needed the doctor) and since Women’s Lib was first taking hold, female patients obviously couldn’t ask an intelligent question. (I’m being sarcastic of course.)
For as far back as I can remember, I was asking the doctor questions. Living with a chronic condition since age 3, I was asking simple things by age 6 or 7 like:
“What is this?”
“Why am I taking this?”
“Why aren’t I feeling well (or any better)?”
All I ever got was a pat on the head and this answer, “There, there, sweetheart, don’t worry about it.”
I didn’t like that answer, even at age 7. And I kept pushing. And my Mother, who was even more intimidated by a doctor, was mortally embarrassed that I would question him.
If you think this changed as I got older, it didn’t. I didn’t care. I was asking questions, yes, but I wasn’t belligerent. I was polite, my questions were straightforward…I was just refusing to be patronized.
And that’s all it takes for anyone: male or female, whether or not English is your native language, your level of education, or if the U.S. is your original home. Don’t be afraid of the doctor! It is his/her job to take care of you.
When I lay my head unto this pillow, I fear not the possibility of death but rather long for it. I can count her freckles, but get lost in her ever changing eyes. The way her jet black hair so smoothly wraps itself around me as if night were forever is the most comforting thing I have felt in the past three years…putting me to sleep like the prescription pills I never took. My drug, my love…will you be here forever? The girl of my dreams…everything I need smirks back at me and then, as quick as it came, the signal is lost and the satellite floats away on it’s path around my world.
I believe in the future. I believe in our future, girl halfway around my mind. Sleep has never felt so good nor have these drugs in which I have deprived myself of for far too long.
As you come closer, your image becomes more clear and your eyes so much more consistent in color. I didn’t know swimming through emerald was possible let alone so invigorating. The colors around me…..the colors around…..us. While we are underwater, let’s share this bubble and call it home. Together, we’ll float no matter how far apart we are, letting the current take control with the knowledge that one day you and I will meet. We are invincible…more so inevitable.
I’m in love with the girl inside my head, so in love.
Judgement Day.
The pathology results of the 13 skin cancers I had carved from my hide last week all came back today, and just as I suspected, none of them were actual skin cancers. Six of the sites were just smudges of dirt, 3 were specks of spaghetti sauce, 2 were splotches of Taco Bell Fire Hot Sauce, one was a small piece of crystallized corned beef hash, and one was listed as “left pinkie toe”. Upon reading that, I ripped off my left sock and sure enough…no pinkie toe. No wonder I have been walking tilted at an angle in circles all week!
OK so maybe I exaggerated just a little. All the pathology results came back as Basal Cell Carcinomas
but I had to frantically try to think up some rational way to explain away the fact that I woke up this morning without a pinkie toe. My loving wife will have a field day with this little nugget as she is always quick to remind me that I would lose my own head if it was not attached to my body. I spent the better part of the morning scouring through the bedding and under the bed but could find no sign of the toe. How in the world does a pinkie toe just up and run away anyway? I somehow suspect that one or more of our Obese House Cats are to blame as I have noticed they tend to drool quite a bit as I shuffle past with bare feet. I am going to try to play this one low key and will pray that the wife does not notice the missing toe anytime soon. I just hope that someday a week or two from now she is not rifling through the fridge looking for a snack and then starts screaming “OH MY GOD!!! WHO THE HELL PUT A PINKIE TOE IN THE REFRIDGERATOR AND DID NOT PUT IT IN A BAGGIE OR TUPPERWARE CONTAINER!!!”
Somewhere in New York City, Cosmo Kramer is recounting the pinkie toe incident to George Costanza and Jerry Seinfeld…
Kramer: Yeah, I found the toe. So I put it in a Cracker Jack box, filled it with ice and took off for the hospital.
George: You ran!?
Kramer: No I jumped on the bus. I told the driver “I got a toe here buddy, step on it!”
George: Holy cow!
Kramer: Yeah, yeah, then all of a sudden, this guy pulls out a gun. Well, I knew any delay is gonna cost the idiot guy in Texas his pinkie toe, so I got out of the seat and I started walking towards him. He says, “Where do you think you’re going, Cracker Jack?” I said, “Well, I got a little prize for ya, buddy – ” – knocked him out cold!
George: How could you do that!?
Kramer: Then everybody is screamin,’ because the driver, he’s passed out from all the commotion…the bus is out of control! So, I grab him by the collar, I take him out of the seat, I get behind the wheel and now I’m drivin’ the bus.
George: You’re Batman!
Kramer: Yeah. Yeah, I am Batman. Then the mugger, he comes to, and he starts chokin’ me! So I’m fightin’ him off with one hand and I kept drivin’ the bus with the other, y’know? Then I managed to open up the door, and I kicked him out the door with my foot, you know – at the next stop.
Jerry:(Incredulous)You kept making all the stops!?
Kramer: Well, people kept ringing the bell!
George: You did all of this for a pinky toe?
Kramer: Well, it’s a valuable appendage.
Jerry: What the hell kind of Idiot loses a Pinkie Toe anyway? What a loser!
3744503 อณูทางการแพทย์ Molecular Medicine
กลไกของการเกิดโรคและการดำเนินของโรคในระดับยีน การใช้เทคนิคอณูชีววิทยาในการทำนายการเกิดโรค การป้องกัน และการรักษาโรค
(Mechanisms of disease development and progression at gene level; use of molecular biology techniques in the prediction, prevention and treatment of diseases.)
(3744503 จุฬาลงกรณ์มหาวิทยาลัย)
