Dame Sheila Patricia Violet Beckett Sherlock was the world's leading female physician-scientist of the twentieth century. Her brilliant, wide-ranging, original contributions to the investigation, diagnosis, classification, epidemiology, pathogenesis and management of liver disease played a leading role in the establishment of hematology as a medical specialty. Her rigorous, highly focused, studies combined experimental and laboratory investigations with meticulous clinical observation, encompassed most aspects of liver function, disease and treatment, and led directly to enormous benefit for millions of patients. Her remarkable individual personality also had a profound influence not only on her medical and scientific specialty but also on several generations of physicians throughout the world. She was the first female professor of medicine and head of a department of medicine in the UK, and the pioneer of women in modern medicine. The importance of her contributions to knowledge and her massive influence on training in and the practice of medicine related to liver disease were recognized by a glittering array of honours and awards from professional societies and academic institutions throughout the world, including 19 honorary degrees, and, very belatedly, election to Fellowship of The Royal Society in the last year of her life. (+info)
Resource and manpower calculations for the provision of hepatobiliary surgical services in the UK.
(58/442)
BACKGROUND: The provision of specialist non-transplant hepatobiliary services in the UK is fragmented and there is little consensus on the manpower and resource requirements to meet the needs of defined populations. METHODS: We report our experience with a hepatobiliary service established 5 years ago in Sheffield to provide a tertiary referral service to the population of the North Trent health area and attempt to provide estimates of resource requirements based on patterns of current use. RESULTS: A total of 615 patients with hepatobiliary conditions requiring specialist treatment were referred to the service during 1997-2002. The majority of patients (69%) were referred for consideration of liver resection for colorectal liver metastases. In all, 251 resections were performed in 240 (39% of all referred) patients. The current operation rates for colorectal metastases are about 4 per 100,000 population per year and for other complex hepatobiliary procedures are also 4 per 100,000 population per year giving a total "need" of 8 procedures per 100,000 population per year. For the current population in England and Wales, this would mean 25 specialist hepatobiliary centres performing in total approximately 2000 hepatic resections for colorectal cancer metastases and 2000 other tertiary hepatobiliary procedures each year. CONCLUSIONS: Our experience supports the model of centralisation of non-transplant hepatobiliary surgical services and indicates the extent of hitherto unmet demand in our geographical area. We estimate that a minimum of two full-time specialist hepatobiliary surgeons with appropriate ancillary support are required for a typical population of 2 million people in the UK. (+info)
The short history of gastroenterology.
(59/442)
In this paper research on the stomach and bowel physiology is presented in a historical perspective. The author tries to show how digestive processes were interpreted by the ancients and how they tried to adjust them to the dominating humoral theory of disease. It is pointed out that the breakthrough which created a new way of understanding of the function of the digestive system was made by Andreas Vesalius and his modern model of anatomy. The meaning of acceptance of chemical processes in digestion by iatrochemics representatives in XVII century is shown. Physiological research in XIX century, which decided about a rapid development of physiology, especially the physiology of the gastrointestinal tract, is discussed. Experiments were performed by all main representatives of this discipline: Claude Bernard, Jan Ewangelista Purkyne, Rudolph Heidenhain and especially Ivan Pavlov, who, thanks to the discoveries in the secretion physiology, explained basic functions of the central nervous system. The XX century was dominated by the research showing the important role of the endocrine system and biological agents in the regulation of secretion and motility of the digestive system. The following discoveries are discussed: Ernest Sterling (secretin), John Edkins (gastrin) and Andre Latarjet and Lester Dragstedt (acetylcholine). It is underlined that Polish scientists play an important role in the development of the gastroenterological science--among others, Walery Jaworski, who made a historical suggestion about the role of the spiral bacteria in etiopathogenesis of the peptic ulcer, Leon Popielski, who stated the stimulating influence of histamine on the stomach acid secretion, Julian Walawski, who discovered enterogastrons--hormones decreasing secretion. As a supplement, there is the list of achievements in the field of the physiology and pathology of the gastrointestinal tract awarded with Nobel Prize and the list of most important Polish papers in this field. (+info)
History and current status of Polish gastroenterological pathology.
(60/442)
The present paper summarizes the contribution of Polish investigators to the development of gastroenterology, and especially pathology of the gastrointestinal tract. We called to mind meritorious scientists among the 19(th)-century and modern pathologists. Especially interesting are discoveries of Browicz, being the first, who described typhus bacilli and shortly after Kupffer - fagocytozing cells in the liver. Noteworthy are detailed description of tumorous lesions being the contribution to oncological pathology of the gastrointestinal tract as well as the reports on congenital malformations (i.e. esophageal fistulas). Moreover we remind the investigators dealing with pathology of gastric ulcer disease, its pathogenesis and mechanisms of healing. Of great importance was also the discovery of regeneration existing also outside the mucosal surfaces. In the paper, besides the above-mentioned Tadeusz Browicz investigations of professors: Lesniowski, Ciechanowski, Kowalczykowa, Stachura, Konturek are called to mind. (+info)
History of Polish gastrointestinal radiology.
(61/442)
As early as several days after the publication of the information concerning Roentgen's discovery the first radiological examinations were performed in Poland. The new method was immediately introduced into medical practice, including gastroenterology. In that pioneer period the most important works were those by Walery Jaworski who was the first man in the world to perform an X-ray of gall stones as well as the stomach with the use of a contrast medium. In its more-than-a-hundred-year history Polish gastrointestinal radiology has attempted not only to catch up with the world science, but it also has made a considerable contribution to its development. (+info)
The past and present of the Polish paediatric gastroenterology, hepatology and nutrition.
(62/442)
Gastroenterology has emerged from paediatrics as a separate discipline after 1978, due to the development of basic sciences, i.e., biochemistry, immunology, pathomorphology and introduction of miniaturized endoscopic and radiological equipment. This paper describes the most significant achievements in the areas of gastroenterology, hepatology, and nutrition in children in particular medical centres in Poland. It also discusses the role of the Polish Society for Paediatric Gastroenterology, Hepatology and Nutrition, the role of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), and the role of other Scientific Societies and Foundations supporting the development of science and education. The emphasis has been placed upon utilitarian research and education with regard to the management of children with gastrointestinal and hepatic disease. (+info)
Gastroenterological research in domestic animals--past, present and future perspectives.
(63/442)
The gastrointestinal research in domestic animals in Poland is briefly discussed in the section. The history starts over seventy years ago with the creation of the Department of Animal Physiology at the Veterinary Faculty of Warsaw University. Professor B. Gutowski, the first head of the Department, and his pupils established the School of Gastrointestinal Physiology; renowned for the achievements in physiology of digestion, gastrointestinal motility, pancreas and liver functions, and comparative physiology of domestic ruminants and wild animals. After the WWII the gastrointestinal research has also been initiated in the newly established faculties of veterinary and animal science of the agricultural universities in Lublin (motility, composition of pepsinogen, biliary and pancreas secretion, vitamin and microelement absorption), Szczecin (lipid absorption, lymph formation), Wroclaw (gastrointestinal and gall bladder motility, bile secretion) as well as in the Institute of Animal Physiology and Nutrition of the Polish Academy of Science (digestion and absorption, development of the gastrointestinal tract in neonates). The research activity was focused on solving the problems faced by animal production in Poland, but it also resulted in a considerable number of physiological findings of an international dimension, and initiated new research areas. (+info)
Recent Advances in Alcoholic Liver Disease I. Role of intestinal permeability and endotoxemia in alcoholic liver disease.
(64/442)
A significant body of evidence indicates that endotoxemia and endotoxin-mediated hepatocellular damage play a crucial role in the pathogenesis of alcoholic liver disease. A close correlation between endotoxemia and the severity of alcohol-induced liver injury is supported by a number of clinical and experimental studies. Elevated intestinal permeability appears to be the major factor involved in the mechanism of alcoholic endotoxemia and the pathogenesis of alcoholic liver disease. Ethanol and its metabolic derivatives, acetaldehyde in particular, alter intracellular signal-transduction pathways leading to the disruption of epithelial tight junctions and an increase in paracellular permeability to macromolecules. Studies addressing the mechanisms of such epithelial disruption and the protective factors that prevent ethanol and acetaldehyde-mediated disruption of epithelial tight junctions are critically important in the investigations toward the search of preventive and therapeutic strategies for alcoholic liver disease. (+info)