The paper presents most frequently used terms for non-alopathic medicine, and they include the following: alternative, unorthodox/unconventional, traditional, fringe, complementary, cross-cultural, ...mind/body, natural, holistic and integrative. All these terms have been discussed in detail and it has been concluded that, from professional and medical perspective, the most adequate term is "integrative medicine", since it fulfills all the prerequisites of modern medical progress and development.
ORGANISATION OF TEACHING INTERNAL MEDICINE: The Department for Internal Medicine and Internal Clinics were founded in spring 1922. Dr. Radenko Stankovic and Dr. Dimitrije Antic were appointed as ...part-time Professors, while Dr. Aleksandar Ignjatovski, a former Full-time Professor of the Warsaw University, was appointed as professor under contract. A year later, Dr. Aleksandar Radosavljevic was appointed as Part-time Professor. In the General State Hospital and Military Hospital, certain wards were turned into clinics. II and III Internal Clinics were situated in the barracks, while the Propedeutic and I Internal Clinics were located in the Military Hospital. Upon the construction of the buildings of the Internal Clinic and General State Hospital, the Propedeutic and I Internal Clinics were permanently placed in the new building, and II and III Internal Clinics in the General State Hospital. Teaching of Internal Medicine started 31 October 1922. Dr. R. Stanko vic delivered a lecture in Propedeutics for students of the fifth term. This date marks the beginning of teaching internal medicine at the newly established School of Medicine, University of Belgrade. Dr. A. Ignjatovski started lecturing Internal medicine 23 March 1923, whereas Dr. D. Antic and and Dr. A. Radosavljevic also delivered lectures in the areas of Internal Medicine within their professional scope. At the beginning, the clinics belonged to the General State Hospital. It was impossible to teach successfully in hospital, therefore upon the professors' request, the clinics were separated and thus became the institutions belonging to the School of Medicine-educational institutions, while hospitals were health institutions. The rule was 'one professor--one clinic'. After the Second World War, teaching Internal Medicine was begun in demolished buildings in very difficult financial circumstances. The Propedeutic Internal clinic was renamed IV Internal Clinic, which continued dealing predominantly with cardiology. III and IV Internal Clinics were placed in the building of the Internal Clinic, II Internal Clinic remained in the General State Hospital and I Internal clinic was moved to the new building of the Institute for Oncology. REFORMS OF SCHOOL OF MEDICINE AND ITS CLINICS: Out of the School of Medicine, Veterinary Medicine, Pharmacy and Stomatology, the Grand Medical School was formed. After several years, it was closed down, and the schools were returned to the University. The most important alteration was made when, according to the Law, the Clinics were isolated from the School and proclaimed hospitals, health institutions and organised into the Clinical Centre of the School of Medicine, then University Clinical Centre, and finally the Clinical Centre of Serbia as the teaching base. Within city hospitals, later on Clinical Hospital Centres, the teaching bases for Internal Medicine and other subjects were established, with introducing self-management and the Law on Associated Labour with independent financing, there came hard times for the School of Medicine and Clinics. The Law had negative effects upon the Schools--University and it had to be abolished. The next step in the reform was merging of I and II Internal Clinics into the Internal B Clinic, within the Clinics, out of specialized departments for certain branches of Internal Medicine there were formed clinics (Clinic for Cardiology, Pulmonology, Endocrinology, Diabetes and Metabolic Diseases and so on). The Internal A Clinic was situated in the building of the General State Hospital and the Internal B Clinic in the building of the Internal Clinic, where there were also III and IV Internal Clinics. CONSTRUCTION OF CLINICAL CENTRE: After a long time, there were created conditions for constructing a new building for locating clinics--the Clinical Centre, the foundation stone was laid 20 October 1976, and the first phase including the polyclinics was completed 1 January 1983. The preliminary concept of the bed capacity of 30 to 50 at Internal Clinics was altered and the Institutes were established. Firstly, the Internal Clinics was altered and the Institutes were established. Firstly, the Internal A and B Clinics were joined into the Basic Organisation of Associated Labour Internal Medicine. Afterwards, certain specialized Internal Clinics with respective surgical branches were linked and the Institutes were established (Institute for Cardiovascular Diseases, Institute for Pulmonology and Tuberculosis, Institute for Endocrinology, Diabetes and Metabolic Diseases and so on). The Institutes were located at the former buildings of the clinics as well as the vacant buildings of the Military Medical Academy, which moved into the new modern building at Banjica. Thus, Internal Medicine was organisationally closed down, while assistants and professors were gathered at the Department for Internal Medicine which represented the organisation for teaching Internal Medicine. Professors and assistants from certain specialized Institutes taught certain disciplines, and at the Clinical Hospital Centre bases where teaching staff was deficient, the Clinical Centre professors were of assistance. A colossal Emergency Centre was established within the Clinical Centre, providing services for the whole of the Republic and beyond, which is completely illogical since it should be the Republic Health Institution rather than the part of the Clinical Centre. Also, the Clinical Centre as the health institution is enormous and represents the teaching base. The first directors were lawyers and, as of recently, professors of the School of Medicine. By separating Clinics from the School of Medicine, teaching and allied staff have a double working status as unique, so financially more potent health sector has gradually pushed aside the teaching one being rather underestimated in such organisation. Ministers for Health and Directors of the Clinical Centre great executive power for appointing directors. There started an uprecedented systematic degradation of teaching staff, since assistant professors or newly appointed associated professors were appointed as managers over their own teachers, full-time professors. It is unusual that those young people accepted their big, delicate roles to manage their professors in front of whom they had taken their board exams or defended their masters' and doctoral theses in not so distant past. There has only been one case of a junior professor refusing to be the director of his own professor. The stationary section of the Clinical Centre including the Internal Clinics was completely constructed but has not been equipped or occupied yet. Deans were authoriZed, by the University Law, to appoint professors and assistants. Thus, a large number of them were appointed without any high scientific and teaching quality standards, and afterwards promoted, while certain highly competent professors were dismissed from the University. By altering the system and passing the new University Law, the situation has improved and the University is returning to its roots. Today, such Clinical Centre as the teaching base of the School of Medicine and the School itself represent a big problem, primarily the financial one. Thus, it will be very hard to re-establish the right relationship between these two institutions.
In vitro lysosomal acid protease activity was studied in human papillary thyroid carcinoma (n = 13). As a control, morphologically normal thyroid tissue from the same patient was used in each ...individual case of carcinoma. Although a marked variation may be observed between individual cases, each examined papillary thyroid carcinoma showed significantly greater activity of acid proteases, both per unit weight of wet thyroid tissue and per unit of lysosomal proteins, in comparison to the corresponding control (range, 24%‐248%). In conclusion, it is suggested that enhanced proteolytic activity of lysosomal acid proteases in papillary carcinoma is probably a result of disturbance in catabolic degradation of the thyroglobulin molecule in malignantly transformed thyroid tissue.
Chronic pulsatile subcutaneous administration of low doses of gonadotrophin releasing hormone (GnRH) is an effective therapy for men with hypogonadotrophic hypogonadism. Hypersensitivity reactions to ...GnRH are rare. We wish to report hypersensitivity reactions with intravenous GnRH after low dose subcutaneous pulsatile GnRH treatment in two men with hypogonadotrophic hypogonadism due to suprasellar disease.
The acute administration of glucocorticoids is a new stimulus of growth hormone (GH) secretion in man. In order to ascertain its point of action, and also the suitability of this new test as a ...diagnostic tool in GH pathological states, 33 subjects were studied. Eight of them were normal controls, and 25 were patients with tumors affecting the hypothalamopituitary area. A glucocorticoid stimulus, dexamethasone 4 mg i.v. was administered at 0 min and GH levels (means +/- SEM, microgram/l) were measured during the following 5 h. In addition, GH-releasing hormone (GHRH) and clonidine were employed as either pituitary or hypothalamic GH stimuli. Dexamethasone administration to normal subjects did not alter GH levels in the first 2 h of the test. Afterwards, a GH peak was observed around the third hour, GH levels returning to basal ones thereafter. The dexamethasone-induced GH peak (6.7 +/- 1.5) and area under the curve (526 +/- 137) were lower than after GHRH (14.0 +/- 4.5 and 1,070 +/- 369, respectively). In the 14 acromegalic patients studied, the GHRH-induced GH net increase was similar to that observed in controls, while the placebo did not alter GH basal levels. An absence of hypothalamic control was evident because clonidine did not stimulate GH release. On the other hand, and contrary to normal subjects, dexamethasone strongly inhibited GH secretion, the values being significantly lower when calculated either as mean GH peak, or maximum GH increment (delta). The delta GH was -2.5 +/- 3.1 after placebo, +3.7 +/- 4.5 after clonidine, +17.0 +/- 3.3 after GHRH and -13.4 +/- 4.5 following dexamethasone administration.
A 55-year-old gentleman, after being treated for a short time with a diet and with Chlorpropamide, was switched to purified porcine insulin due to ketonuria and ketoacidosis. After a year the patient ...developed immunological insulin resistance (mean daily insulin dose: 3.72 U/kg body weight; anti-insulin antibodies 78%). In order to lower anti-insulin antibodies human recombinant DNA insulin was introduced into further therapy. Contrary to expectations, the patient did not reduce whatsoever his anti-insulin antibodies and his daily insulin dose increased up to 5.63 U/kg body weight. Introduction of combined immunosuppressive therapy (prednisone plus azathioprine) together with plasmapheresis resulted in rapid lowering of daily insulin requirement and reduction in anti-insulin antibodies. Immunosuppressive therapy was continued with 10 mg of prednisone and a year later the patients insulin daily requirement was 0.66 U/kg BW while his antibodies were 18%. The possible causes of insulin resistance to human recombinant DNA insulin are discussed as well as the advantage of combined immunosuppressive therapy together with plasmapheresis that was used for rapid lowering of insulin daily requirement and anti-insulin antibodies titer.
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