Abraham Fuks | McGill University (original) (raw)
Papers by Abraham Fuks
Oxford University Press eBooks, Nov 22, 2021
Metaphors are ubiquitous features of spoken and written language that permit us to experience one... more Metaphors are ubiquitous features of spoken and written language that permit us to experience one thing in terms of another. “Seeing is believing” helps us understand the abstract concept of belief in terms of the concrete sense of sight. Derived from two Greek words that mean “to transfer,” metaphors transfer certain attributes from the source domain, in our example, Seeing to the target domain of Believing. The chapter explores how metaphors have cognitive properties and allow us to learn new things and to express abstract ideas and complex relations. Metaphors are a powerful trope of figurative language and commonly appear in both formal medical writings and the informal daily interactions of doctors, patients, and the public more generally. The chapter describes how metaphors connect abstract and concrete domains and offers an array of examples that helps us decipher how metaphors originate from human experiences and how they evolve. It explores how metaphors frame perceptions and shape reality and their potency in the language of the clinic.
PubMed, 1978
1. Birth Defects Orig Artic Ser. 1978;14(2):235-46. Isolation and structure of HLA antigens. Stro... more 1. Birth Defects Orig Artic Ser. 1978;14(2):235-46. Isolation and structure of HLA antigens. Strominger JL, Ferguson W, Fuks A, Giphart M, Kaufman J, Mann D, Orr H, Parham P, Robb R, Terhorst C. PMID: 76486 [PubMed - indexed for MEDLINE]. Publication Types: ...
PubMed, May 1, 1982
Reticuloendothelial system Fc receptor function was measured in 10 patients with systemic lupus e... more Reticuloendothelial system Fc receptor function was measured in 10 patients with systemic lupus erythematosus (SLE) taking corticosteroids, 10 SLE patients not receiving corticosteroids and in 19 controls, 9 of whom were corticosteroid-dependent asthmatics and 10 of whom were healthy. Clearance studies were performed using autologous 51 Cr-labeled erythrocytes that had been sensitized with human IgG anti-Rh(D) [6,700 molecules/cell]. The clearance curves could be split into a fast (t1/2 fast) and a slow (t1/2 slow for any of the groups of patients. The results were correlated with serum C3, C4, DNA-binding, fluid phase 125I-Clq binding, a disease activity index, corticosteroid dose and duration of therapy with corticosteroids. The only significant correlation was an inverse correlation of C4 with the t1/2 slow in SLE patients not on corticosteroids (r=- 0.71, p less than 0.05). The t1/2 slow of the 3 SLE patients with active nephritis (86 +/- 40 min) was significantly different from the 17 SLE patients with inactive nephritis or normal renal function (37 +/- 5 min) (P less than 0.05). We conclude that there is no overall defect of Fc receptor function in our patients with SLE although there is decreased clearance in patients with active lupus nephritis.
PubMed, 1990
Syndromes of insulin-dependent diabetes mellitus (IDDM) have been described in the mouse, in the ... more Syndromes of insulin-dependent diabetes mellitus (IDDM) have been described in the mouse, in the rat and in man. In all three species, the presence of one or more specific alleles of the major histocompatibility complex is a prerequisite for the appearance of the disease. In the BB rat, diabetes is associated with the RT1u haplotype. We have performed a series of intercrosses of diabetic BB rats with normal Lewis and Buffalo rats and examined the offspring of all litters producing at least one diabetic animal. Forty-five of the 250 rats that developed diabetes were heterozygous for the RT1u haplotype by serotyping. Furthermore, the diabetic rats heterozygous by serotyping at the RT1A class I loci were also heterozygous at the RT1B and RT1D loci of the class II region and did not show evidence of a recombinant haplotype when examined by Southern blot analyses using molecular probes for class I and class II genes. Diabetic rats heterozygous or homozygous for RT1u were phenotypically indistinguishable with respect to age of onset and severity of disease. Therefore, in the rat, as in the human, a single dose of the high-risk allele at the major histocompatibility complex is sufficient for the development of IDDM if other susceptibility factors and the appropriate environmental factors are in place.
PubMed, 1989
The spontaneous development of diabetes in the Bio-Breeding (BB) rat is an excellent model of hum... more The spontaneous development of diabetes in the Bio-Breeding (BB) rat is an excellent model of human insulin-dependent diabetes mellitus (IDDM). Disease expression is dependent on several genetically determined abnormalities, including specific major histocompatibility complex (MHC) genes. At least one MHC class II locus of the U haplotype is a necessary, but not sufficient, condition for disease expression. The immune system of BB rats is markedly abnormal. There is a striking reduction in the number and function of mature cytotoxic/suppressor T cells, a poor proliferative response to mitogens and in mixed lymphocyte culture, poor interleukin-2 production, and a reduced ability to reject skin allografts. While these immune system abnormalities are closely related to the development of diabetes, the immune recognition and effector mechanisms resulting in islet cell destruction are still poorly understood. The hypothesis that MHC class II induction on pancreatic beta cells serves to target these lymphokines, natural killer (NK) cells, macrophages, etc.) have been implicated in islet cell killing. The incidence of IDDM is reduced by immunosuppressive therapy in both rats and humans, further supporting the role of immune mechanisms in this disease.
Perspectives in Biology and Medicine, Jun 1, 2023
ABSTRACT: The objective of this essay is to develop the argument that placebos are a species of m... more ABSTRACT: The objective of this essay is to develop the argument that placebos are a species of metaphor and to demonstrate that an analysis of the figurative trope can help us elucidate the power of the placebo response. The cognitive and embodied responses to both metaphors and placebos stem from the transfer of meaning between two domains, each with rich allusive properties that in turn depend on highly ramified and interconnected neural webs. Metaphors and placebos require an appropriate cultural backdrop for their linguistic and cognitive work and are dependent on shared social forms of life. More specifically, metaphors rely on an intersubjective connection and imply that a relational entanglement between doctor and patient is necessary to the effect of placebos in the clinical setting.
Proceedings of the National Academy of Sciences of the United States of America, Aug 1, 1977
CRC Press eBooks, Nov 30, 2022
Oxford University Press eBooks, Nov 22, 2021
Words are the ties that bind patient and physician in the clinical relationship in which medical ... more Words are the ties that bind patient and physician in the clinical relationship in which medical care is enacted. The first chapter, “The Lens of Language,” shows how language mediates both the communicative and relational aspects of the practice of medicine. It compares the descriptive mode of language used to transmit straightforward factual information with figurative language. The latter uses metaphors and allusions with multiple meanings that require interpretation and enable the creation of new ideas and thoughts. Figurative language is suited to communication of nuances and emotions and is dependent on context to provide meaning. Clinical stories told by patients are rich with words that are linked to past experiences and reveal to an attentive physician the important concerns of the patient, such as the shock of illness and the fear of disease. The chapter explores the idea that language constitutes what can be called the “house of being.”
Oxford University Press eBooks, Nov 22, 2021
This chapter examines the importance of listening in clinical care. Our society values speaking o... more This chapter examines the importance of listening in clinical care. Our society values speaking over listening, yet patients and their families consistently yearn for a physician who will listen. Listening leads to the garnering of important information and concurrently signals respect for the patient. The chapter explores why listening is poorly understood and underappreciated; it describes the modes of social listening and offers a taxonomy of clinical listening. Attentive listening is undermined by the increasing speed of social interactions and the rapid pace of patient visits, to the detriment of optimal health care. The chapter showcases the maieutic quality of listening in giving birth to the words of the speaker and the interpretive nature of hearing. Clinicians must learn the features of attentive listening that signal authentic engagement with patients and the nature of its power to heal. The chapter concludes with a comparison of the two traditional scholarly frameworks for knowing the world.
Humana Press eBooks, 1992
Philosophy, Ethics, and Humanities in Medicine, Feb 21, 2019
Oxford University Press eBooks, Mar 22, 2018
We provide the overall framework for the Physicianship Curriculum. It is based on common clinical... more We provide the overall framework for the Physicianship Curriculum. It is based on common clinical presentations, as described in the medical literature. We develop the fundamental questions and issues that are likely to be in the minds of a patient and physician during a medical encounter. These issues frame clinical thinking with respect to assessment and treatment and inform the content of the educational program. The primary objectives of each curricular phase are outlined. We articulate the specific roles of teachers and mentors and propose a set of teaching methods, adopted, in part, from the broader literature in educational research.
Oxford University Press eBooks, Mar 22, 2018
The historical roots of competency-based approaches to education are presented. The word competen... more The historical roots of competency-based approaches to education are presented. The word competency and its cognates competence, competent, and competencies are defined. The conditions that have permitted the competency-based movement to become entrenched in many national and pan-national institutions are discussed. There is an overwhelming perception by opinion leaders that learners are currently not subject to sufficiently valid and robust assessments of clinical performance. Competency-based approaches are considered promising as they provide protocols for frequent assessments. Clinical teachers sometimes visualize these assessment strategies as providing “educational biopsies” of learners’ skills and so-called competencies. Design considerations in competency-based approaches, namely, the concepts of entrustability, graded levels of proficiency, and performance milestones, are discussed. The chapter ends with opinions on the theoretical advantages and disadvantages of this approach.
Oxford University Press eBooks, Mar 22, 2018
PubMed, 1986
Nine monoclonal antibodies reacting with carcinoembryonic antigen (CEA) were produced after immun... more Nine monoclonal antibodies reacting with carcinoembryonic antigen (CEA) were produced after immunization of mice with either purified CEA or a CEA-producing human cell line. Their specificities were assessed by immunohistochemistry on tissue sections of neoplastic and nonneoplastic lesions. These monoclonal antibodies have different patterns of tissue reactivity. Two of them, D14 and B18, were found to have a high degree of specificity for colonic carcinoma and did not react with formalin-fixed paraffin-embedded sections of normal colon with standardized staining conditions. Most cases of noncolonic adenocarcinomas and normal epithelial structures were not stained by these two monoclonal antibodies. The specificity of the monoclonal antibodies was further investigated immunochemically using intact, reduced, and alkylated or chemically fragmented CEA. Liquid phase radioimmunoassays and antibody competition immunoenzymatic assays confirmed that the antibodies recognize different epitopes of CEA. These data support the concept of CEA heterogeneity and the reactivity of the D14 and B18 monoclonal antibodies with colonic adenocarcinomas indicates that they are useful immunohistochemical probes.
CRC Press eBooks, Nov 30, 2022
Oxford University Press eBooks, Nov 22, 2021
Metaphors are ubiquitous features of spoken and written language that permit us to experience one... more Metaphors are ubiquitous features of spoken and written language that permit us to experience one thing in terms of another. “Seeing is believing” helps us understand the abstract concept of belief in terms of the concrete sense of sight. Derived from two Greek words that mean “to transfer,” metaphors transfer certain attributes from the source domain, in our example, Seeing to the target domain of Believing. The chapter explores how metaphors have cognitive properties and allow us to learn new things and to express abstract ideas and complex relations. Metaphors are a powerful trope of figurative language and commonly appear in both formal medical writings and the informal daily interactions of doctors, patients, and the public more generally. The chapter describes how metaphors connect abstract and concrete domains and offers an array of examples that helps us decipher how metaphors originate from human experiences and how they evolve. It explores how metaphors frame perceptions and shape reality and their potency in the language of the clinic.
PubMed, 1978
1. Birth Defects Orig Artic Ser. 1978;14(2):235-46. Isolation and structure of HLA antigens. Stro... more 1. Birth Defects Orig Artic Ser. 1978;14(2):235-46. Isolation and structure of HLA antigens. Strominger JL, Ferguson W, Fuks A, Giphart M, Kaufman J, Mann D, Orr H, Parham P, Robb R, Terhorst C. PMID: 76486 [PubMed - indexed for MEDLINE]. Publication Types: ...
PubMed, May 1, 1982
Reticuloendothelial system Fc receptor function was measured in 10 patients with systemic lupus e... more Reticuloendothelial system Fc receptor function was measured in 10 patients with systemic lupus erythematosus (SLE) taking corticosteroids, 10 SLE patients not receiving corticosteroids and in 19 controls, 9 of whom were corticosteroid-dependent asthmatics and 10 of whom were healthy. Clearance studies were performed using autologous 51 Cr-labeled erythrocytes that had been sensitized with human IgG anti-Rh(D) [6,700 molecules/cell]. The clearance curves could be split into a fast (t1/2 fast) and a slow (t1/2 slow for any of the groups of patients. The results were correlated with serum C3, C4, DNA-binding, fluid phase 125I-Clq binding, a disease activity index, corticosteroid dose and duration of therapy with corticosteroids. The only significant correlation was an inverse correlation of C4 with the t1/2 slow in SLE patients not on corticosteroids (r=- 0.71, p less than 0.05). The t1/2 slow of the 3 SLE patients with active nephritis (86 +/- 40 min) was significantly different from the 17 SLE patients with inactive nephritis or normal renal function (37 +/- 5 min) (P less than 0.05). We conclude that there is no overall defect of Fc receptor function in our patients with SLE although there is decreased clearance in patients with active lupus nephritis.
PubMed, 1990
Syndromes of insulin-dependent diabetes mellitus (IDDM) have been described in the mouse, in the ... more Syndromes of insulin-dependent diabetes mellitus (IDDM) have been described in the mouse, in the rat and in man. In all three species, the presence of one or more specific alleles of the major histocompatibility complex is a prerequisite for the appearance of the disease. In the BB rat, diabetes is associated with the RT1u haplotype. We have performed a series of intercrosses of diabetic BB rats with normal Lewis and Buffalo rats and examined the offspring of all litters producing at least one diabetic animal. Forty-five of the 250 rats that developed diabetes were heterozygous for the RT1u haplotype by serotyping. Furthermore, the diabetic rats heterozygous by serotyping at the RT1A class I loci were also heterozygous at the RT1B and RT1D loci of the class II region and did not show evidence of a recombinant haplotype when examined by Southern blot analyses using molecular probes for class I and class II genes. Diabetic rats heterozygous or homozygous for RT1u were phenotypically indistinguishable with respect to age of onset and severity of disease. Therefore, in the rat, as in the human, a single dose of the high-risk allele at the major histocompatibility complex is sufficient for the development of IDDM if other susceptibility factors and the appropriate environmental factors are in place.
PubMed, 1989
The spontaneous development of diabetes in the Bio-Breeding (BB) rat is an excellent model of hum... more The spontaneous development of diabetes in the Bio-Breeding (BB) rat is an excellent model of human insulin-dependent diabetes mellitus (IDDM). Disease expression is dependent on several genetically determined abnormalities, including specific major histocompatibility complex (MHC) genes. At least one MHC class II locus of the U haplotype is a necessary, but not sufficient, condition for disease expression. The immune system of BB rats is markedly abnormal. There is a striking reduction in the number and function of mature cytotoxic/suppressor T cells, a poor proliferative response to mitogens and in mixed lymphocyte culture, poor interleukin-2 production, and a reduced ability to reject skin allografts. While these immune system abnormalities are closely related to the development of diabetes, the immune recognition and effector mechanisms resulting in islet cell destruction are still poorly understood. The hypothesis that MHC class II induction on pancreatic beta cells serves to target these lymphokines, natural killer (NK) cells, macrophages, etc.) have been implicated in islet cell killing. The incidence of IDDM is reduced by immunosuppressive therapy in both rats and humans, further supporting the role of immune mechanisms in this disease.
Perspectives in Biology and Medicine, Jun 1, 2023
ABSTRACT: The objective of this essay is to develop the argument that placebos are a species of m... more ABSTRACT: The objective of this essay is to develop the argument that placebos are a species of metaphor and to demonstrate that an analysis of the figurative trope can help us elucidate the power of the placebo response. The cognitive and embodied responses to both metaphors and placebos stem from the transfer of meaning between two domains, each with rich allusive properties that in turn depend on highly ramified and interconnected neural webs. Metaphors and placebos require an appropriate cultural backdrop for their linguistic and cognitive work and are dependent on shared social forms of life. More specifically, metaphors rely on an intersubjective connection and imply that a relational entanglement between doctor and patient is necessary to the effect of placebos in the clinical setting.
Proceedings of the National Academy of Sciences of the United States of America, Aug 1, 1977
CRC Press eBooks, Nov 30, 2022
Oxford University Press eBooks, Nov 22, 2021
Words are the ties that bind patient and physician in the clinical relationship in which medical ... more Words are the ties that bind patient and physician in the clinical relationship in which medical care is enacted. The first chapter, “The Lens of Language,” shows how language mediates both the communicative and relational aspects of the practice of medicine. It compares the descriptive mode of language used to transmit straightforward factual information with figurative language. The latter uses metaphors and allusions with multiple meanings that require interpretation and enable the creation of new ideas and thoughts. Figurative language is suited to communication of nuances and emotions and is dependent on context to provide meaning. Clinical stories told by patients are rich with words that are linked to past experiences and reveal to an attentive physician the important concerns of the patient, such as the shock of illness and the fear of disease. The chapter explores the idea that language constitutes what can be called the “house of being.”
Oxford University Press eBooks, Nov 22, 2021
This chapter examines the importance of listening in clinical care. Our society values speaking o... more This chapter examines the importance of listening in clinical care. Our society values speaking over listening, yet patients and their families consistently yearn for a physician who will listen. Listening leads to the garnering of important information and concurrently signals respect for the patient. The chapter explores why listening is poorly understood and underappreciated; it describes the modes of social listening and offers a taxonomy of clinical listening. Attentive listening is undermined by the increasing speed of social interactions and the rapid pace of patient visits, to the detriment of optimal health care. The chapter showcases the maieutic quality of listening in giving birth to the words of the speaker and the interpretive nature of hearing. Clinicians must learn the features of attentive listening that signal authentic engagement with patients and the nature of its power to heal. The chapter concludes with a comparison of the two traditional scholarly frameworks for knowing the world.
Humana Press eBooks, 1992
Philosophy, Ethics, and Humanities in Medicine, Feb 21, 2019
Oxford University Press eBooks, Mar 22, 2018
We provide the overall framework for the Physicianship Curriculum. It is based on common clinical... more We provide the overall framework for the Physicianship Curriculum. It is based on common clinical presentations, as described in the medical literature. We develop the fundamental questions and issues that are likely to be in the minds of a patient and physician during a medical encounter. These issues frame clinical thinking with respect to assessment and treatment and inform the content of the educational program. The primary objectives of each curricular phase are outlined. We articulate the specific roles of teachers and mentors and propose a set of teaching methods, adopted, in part, from the broader literature in educational research.
Oxford University Press eBooks, Mar 22, 2018
The historical roots of competency-based approaches to education are presented. The word competen... more The historical roots of competency-based approaches to education are presented. The word competency and its cognates competence, competent, and competencies are defined. The conditions that have permitted the competency-based movement to become entrenched in many national and pan-national institutions are discussed. There is an overwhelming perception by opinion leaders that learners are currently not subject to sufficiently valid and robust assessments of clinical performance. Competency-based approaches are considered promising as they provide protocols for frequent assessments. Clinical teachers sometimes visualize these assessment strategies as providing “educational biopsies” of learners’ skills and so-called competencies. Design considerations in competency-based approaches, namely, the concepts of entrustability, graded levels of proficiency, and performance milestones, are discussed. The chapter ends with opinions on the theoretical advantages and disadvantages of this approach.
Oxford University Press eBooks, Mar 22, 2018
PubMed, 1986
Nine monoclonal antibodies reacting with carcinoembryonic antigen (CEA) were produced after immun... more Nine monoclonal antibodies reacting with carcinoembryonic antigen (CEA) were produced after immunization of mice with either purified CEA or a CEA-producing human cell line. Their specificities were assessed by immunohistochemistry on tissue sections of neoplastic and nonneoplastic lesions. These monoclonal antibodies have different patterns of tissue reactivity. Two of them, D14 and B18, were found to have a high degree of specificity for colonic carcinoma and did not react with formalin-fixed paraffin-embedded sections of normal colon with standardized staining conditions. Most cases of noncolonic adenocarcinomas and normal epithelial structures were not stained by these two monoclonal antibodies. The specificity of the monoclonal antibodies was further investigated immunochemically using intact, reduced, and alkylated or chemically fragmented CEA. Liquid phase radioimmunoassays and antibody competition immunoenzymatic assays confirmed that the antibodies recognize different epitopes of CEA. These data support the concept of CEA heterogeneity and the reactivity of the D14 and B18 monoclonal antibodies with colonic adenocarcinomas indicates that they are useful immunohistochemical probes.
CRC Press eBooks, Nov 30, 2022