Edmund Randerath (1899-1961): experimental proof for the glomerular origin of proteinuria.
(57/5154)
A century ago, Edmund Randerath (1899-1961), who was one of the pioneers in nephrology that provided indirect experimental proof for the glomerular origin of proteinuria, was born. In the first decades of this century, the concept prevailed that "nephrosis" was a process of primary tubular cell degeneration. In contrast to prevailing opinion, he interpreted these changes to be the result of the uptake and storage of serum proteins after they had been filtered in the glomerulus. Edmund Randerath proved the glomerular origin of proteinuria by astute experiments in amphibia. In the salamander, an intraperitoneal injection of albumin provoked the supposedly "degenerative" changes of tubular epithelial cells in only those nephrons that drained the coelomic cavity and were devoid of glomeruli, but not in those nephrons that were closed and attached to glomeruli. This observation provided incontrovertible evidence that the presence of serum proteins in tubular fluid was a prerequisite for the development of the tubular epithelial cell changes typically seen in nephrotic patients. (+info)
The history and development of cardiac transplantation.
(58/5154)
The history of heart surgery, spanning only 100 years to date, has seen some of the most daring and persistent men and women in all of medical history. Many aspects of heart surgery, including such innovations as the heart-lung machine, aortic aneurysm surgery, and the correction of congenital heart defects, have provided future surgeons with an important lesson: diligent research can solve complex problems. The history and development of cardiac transplantation is particularly full of challenges that have been overcome, with the research phase alone spanning more than 90 years. During that time, essential contributions came from all over the world, including the United States, Russia, England, and South Africa. As is typical of medical advancement, individual contributions did not stand alone but added to the experience of those who had come before. Even so, the work of a few particular groups deserves special recognition. Most notable is the Stanford team, led by Dr. Norman Shumway, who continued to transplant human hearts when other institutions had abandoned hopes for the operation. Largely because of the commitment of that team, cardiac transplantation has become a standard option in the treatment of end-stage heart disease. Currently, only the availability of donor hearts limits the number of cardiac transplantations performed worldwide. (+info)
Dr. Kiyoshi Shiga: discoverer of the dysentery bacillus.
(59/5154)
The clinical manifestations of dysentery have been described for centuries, and the prototypic bacterial agent, Shigella dysenteriae, was identified 100 years ago. In the English language there has been remarkably little written about Dr. Kiyoshi Shiga, discoverer of the dysentery bacillus. We submit a brief biography of Dr. Shiga and the circumstances leading to his discovery, which proved the bacterial etiology of nonamebic dysentery. (+info)
A century of pathology at Yale: personal reflections.
(60/5154)
This history is largely about the players on the stage of the Yale Pathology Department acting out their roles as observed by the author in over a half century as a member of the department and as associate dean of the medical school. (+info)
Did Osler suffer from "paranoia antitherapeuticum baltimorensis"? A comparative content analysis of The Principles and Practice of Medicine and Harrison's Principles of Internal Medicine, 11th edition.
(61/5154)
One of the most important legacies of Sir William Osler was his textbook The Principles and Practice of Medicine. A common criticism of the book when it was first published was its deficiency in the area of therapeutics. In this article, the 1st edition of The Principles and Practice of Medicine is compared with the 11th edition of Harrison's Principles of Internal Medicine. The analysis focuses on the treatment recommendations for 4 conditions that were covered in both books (diabetes mellitus, ischemic heart disease, pneumonia and typhoid fever). Osler's textbook dealt with typhoid fever and pneumonia at greater length, whereas Harrison's placed more emphasis on diabetes mellitus and ischemic heart disease. Notwithstanding Osler's reputation as a therapeutic nihilist, the 2 books devoted equivalent space to treatment (in terms of proportion of total sentences for the conditions). For all conditions except ischemic heart disease, Osler concentrated on general measures and symptomatic care. Throughout Osler's textbook numerous negative comments are made about the medicinal treatment of various conditions. A more accurate statement about Osler's therapeutic approach was that he was a "medicinal nihilist." His demand for proof of efficacy before use of a medication remains relevant. (+info)
Osler usque ad mare: the SS William Osler.
(62/5154)
William Osler's connections with the sea included a strong family history of seafaring, his own transatlantic crossings (of which there were at least 32) and the occasional use of nautical imagery in his inspirational writings. An unusual Oslerian connection with the sea emerged after his death in the form of a World War II Liberty ship. Through the SS William Osler and its sister ships, Osler was symbolically reunited with colleagues associated with the early days of the Johns Hopkins Hospital. The William Osler circumnavigated the globe in 1943 without engaging the enemy. She was then converted into an army hospital ship and renamed the USHS Wisteria. (+info)
Medical research in the Rhondda valleys.
(63/5154)
This brief review has highlighted some of the research done by the MRC in the South Wales valleys. The two MRC Units published, in total, over 2000 reports ranging from letters to journals to conference proceedings, with around 200 reports appearing in the BMJ, Lancet and Nature alone. The expertise gained in South Wales meant that the Pneumoconiosis Research Unit team was involved internationally in co-ordinating research on coal workers' lung disease, and later on the health effects of asbestos and other respirable dusts. It is remarkable that the early large-scale studies were conducted and analysed without the benefits of modern computers and statistical packages. The varied Epidemiology Unit research programme enabled Cochrane to develop his ideas on defining health and evaluating health services, and also Elwood, who directed the Unit from 1974 to 1995, to pioneer studies of aspirin prophylaxis in cardiovascular disease. A steady stream of occupational health studies were carried out by Epidemiology Unit staff and many other large surveys were conducted in other parts of South Wales and across the country. Later MRC Epidemiology Unit work has focused on the town of Caerphilly where a prospective study of some 2500 men, established in 1979, has so far resulted in over 100 papers, notably on haemostatic factors related to heart disease. The study has run in tandem with a similar survey in the Speedwell area of Bristol which was established by former Epidemiology Unit staff working for the health authority in that area. Other medical research groups have also worked in the South Wales valleys. In 1961 Julian Tudor Hart left the Epidemiology Unit after a year's research to enter general practice, and establish the famous research practice at Glyncorrwg, over the mountain from the Rhondda Fawr. This year the extensive collection of MRC survey records is being transferred to the Department of Social Medicine at Bristol, and it is quite likely that further research will be undertaken relating Rhondda survey data collected over 40 years ago to subsequent mortality. The South Wales valleys will continue to contribute to medical research into the next millennium. Archie Cochrane's papers have been catalogued and are available for study at the Cochrane Archive established at Llandough Hospital. (+info)
In memoriam of David P. Rall.
(64/5154)
As a scientist, administrator, and diplomat, David P. Rall pioneered the effort to identify and understand the elements that make up the human environment and their consequences for human health. As an intellectual and aggressive activist, he educated scientists, governments, and the world community to the critical need to address the existence of environmental agents and their consequences for human health. As a leader he marshalled some of the best minds and hearts of his time to the cause of world health through a safe and clean environment. And as a visionary he provided the goals of environmental health science and the direction to guide both current and future generations. His death on September 28 brought to a close a chapter in the evolution of our understanding of the interconnectedness of human health and the environment, a chapter he was largely responsible for writing. (+info)