Léon Athanase Gosselin (1815–1887) et ses recherches sur les maladies du testicule

Leon Athanase Gosselin was one of the greatest French surgeons of the 19th century. He successfully directed many university surgical departments and excelled in orthopaedics, anatomy, physiology and urology. Thanks to his advanced research into testicular, scrotal and spermatic cord diseases and their effects on fertilisation and virility, Gosselin is rightly considered to have been a great andrologist before this branch of medical science had been recognised.     

Evidence for corticotropin releasing factor (CRF) synthesis in the preoptic nucleus of Xenopus laevis tadpoles

Summary For the study of the hypothalamo-hypophysial system of Xenopus laevis tadpoles, hypothalamic lesions were made by means of the electrocoagulation technique. Lesioning of the ventral region of the preoptic nucleus resulted in a decrease of the number of ACTH cells in the pars distalis of the pituitary gland and in a diminution of the PAS-positive reaction of these cells. In addition, regeneration of the neurosecretory cells of the ventral region of the preoptic nucleus observed 6 weeks after lesioning was accompanied by the reappearance of normal PAS-positive ACTH cells in the pars distalis. It is suggested that the neurosecretory cells of the ventral region of the preoptic nucleus of Xenopus laevis tadpoles are related to the ACTH synthesizing cells, probably by producing CRF.Dedicated to Prof. Dr. med. W. Bargmann on the occasion of his 70th birthdayThe authors thank Prof. Dr. J.C. van de Kamer for his interest, Prof. Dr. P.G.W.J. van Oordt for his many helpful comments, and Messrs. H. van Kooten, E. van der Vlist, J.J. van der Vlis and M.C.A. van Pinxteren for preparing the illustrations     

Henk van den Bosch: chemist and biochemist

Henk van den Bosch is a native of The Netherlands and recently retired from his position as Professor at Utrecht University. This article summarizes the many scientific achievements of Dr. van den Bosch. He enjoys an international reputation for his research on phospholipases A, cardiolipin biosynthesis in eukaryotes, lysophospholipases, phosphatidylcholine biosynthesis for lung surfactant, plasmalogen biosynthesis in peroxisomes, diagnosis of peroxisomal disorders and most recently his work on alkyl-dihydroxyacetone phosphate synthase. During his research career Henk van den Bosch published approximately 280 articles and presented 110 invited lectures.     

Patients' prerogatives and perceptions of benefit.

Patients today demand more information about their treatment. Doctors, however, seem reluctant to cast aside ingrained habits of paternalism, believing they can best interpret therapeutic choices for their patients. Whether doctors can be more objective and effective than patients in interpreting the "probabilities" of medical evidence is open to question. On the other hand, the exercise of choice by patients may itself have a bearing on the probabilities of outcome. Involving patients more in making therapeutic choices is justified if doctors can present options in an unbiased and effective manner and if the process improves the outcome of the care delivered.     

L’anatomie andrologique dans les écrits de Jules Germain Cloquet (1790–1883), grand chirurgien et anatomiste

Cloquet was a great anatomist and surgeon. A large proportion of his writings, covering different fields of medicine, such as normal anatomy and physiology, pathology, natural history, and surgery, concerns andrological anatomy illustrating the astonishingly high level of Cloquet’s knowledge in the field of andrology.     

An appreciation of A.E. Malloch,MB, MD (1844-1919): a forgotten surgical pioneer

Dr. Archibald Edward Malloch was a surgeon whose life and work were greatly influenced by Joseph Lister and his revolutionary system of antiseptic surgery. This paper describes how a young Canadian medical man came to introduce Lister''s system to North America in 1869 and studies his career in the light of Lister''s surgical epoch.     

González-Ulloa's Manifesto on aesthetic surgery

The realization that the proper development of aesthetic surgery was hindered by a bias against such practice by departmental heads and editors of medical journals led Dr. Mario González-Ulloa from Mexico to formulate a "Manifesto" on this speciality in the 1960s. This Manifesto has been of utmost importance to our speciality because it served to disseminate responsible opinion concerning aesthetic surgery among specialists. Although the bare text of the Manifesto was published in 1966, its content has so far been lost to future generations of plastic surgeons. Because its place in the history of aesthetic plastic surgery needs to be acknowledged, González-Ulloa's Manifesto is presented and discussed here.     

Semmelweis' discovery and its Finnish follow-up

Professor Ignác Semmelweis (1818-1865) is one of the great personalities of medical history. He insisted on washing hands with chlorine water before any obstetrical intervention, he was the first to demonstrate its importance in preventing puerperal fever. Thus, the principle of asepsis was introduced prior to the discovery of bacteria and bacterial diseases. Semmelweis carefully documented his findings and in this way pioneered the scientific analysis of clinical data Medical community of that time misinterpreted Semmelweis' great ideas, he died abandoned and forgotten. A Finnish doctor Josef Adam Joachim Pippingsk?ld was one of the first obstetricians who had realized the importance of Semmelweis' work. In 1861, in his letter to Semmelweis he reported about his own findings and favorable results in prevention of puerperal fever in Helsinki. Two decades earlier, Dr. Ehrstr?m in the University of Helsinki had submitted his thesis on pathophysiology of puerperal fever that was similar to the ideas of Semmelweis. Long before modern times in Finland, mothers traditionally had their babies delivered in smoke saunas, where heating and smoke of bactericidal phenols created a clean, rather aseptic environment. Hand washing was self-evident necessity. However, the situation was quite different in the Central European universities and departments of obstetrics, where the medical training and clinical practice took place side by side. Semmelweis' life and his contribution to medicine was appreciated even in the theatrical circles of Finland. The piece "Semmelweis" of Norwegian playwright Jens Bj?rneboe got its World Premier in the Swedish Theatre in Turku, former capital of Finland, in September 1969.     

The birth of chemotherapy at Yale. Bicentennial lecture series: Surgery Grand Round

Chemotherapy, one of the mainstays of cancer treatment today, was pioneered at Yale during World War II. Last year, two Yale surgeons, Drs. John Fenn and Robert Udelsman, sought to unearth the mystery surrounding the discovery of chemotherapy and its first use at Yale. The first chemotherapy patient is known only as JD in the literature, and without a name, date of birth, or medical record number, a search for his record seemed futile. However, persistence coupled with sheer fortune led them to JD's chart, where they found information that differed from previous accounts. The riveting personal story of JD, an immigrant patient with lymphosarcoma, was revealed for the first time by Drs. Fenn and Udelsman on January 19, 2011, at a special Surgical Grand Rounds celebrating the bicentennial of Yale School of Medicine.     

Elimination of Mycoplasma from various cell cultures

Elimination ofMycoplasma orale-I from chronically infected cell lines was achieved either by treatment with a mixture of antibiotics in a hypotonic solution, or with 10 vol % of anti -M.orale rabbit serum in tissue culture medium. The latter treatment was preferable in most cases, as it was practically harmless to the cells. Inactivation of this antiserum had no effect on its potency. The antibiotic-hypotonic treatment was rather destructive, but to a different degree for the various cell cultures. Both methods were equally useful for the treatment of a monkey kidney cell line contaminated with a mycoplasma strain related toM.hyorhinis. The available anti -M.hyorhinis rabbit serum was toxic for the monkey cells when not inactivated. The potency of the antiserum was rather low and even lower after inactivation. However, prolonged treatment successfully eliminated the mycoplasma. Pre-incubation of the inactivated anti -M.hyorhinis serum with tissue culture medium to which 10% non-inactivated calf serum had been added, favoured the elimination of the mycoplasma.During the treatment of contaminated cell cultures with single antibiotics a strain related toM.hyorhinis became resistant to chlortetracyclin.M.orale- I was found to be resistant to various single antibiotics.We are grateful to Professor Dr. A. Ch. Ruys (University of Amsterdam) and Dr. R. H. Leach (Mycoplasma Reference Laboratory, London) for helpful discussions and for identifying some of our mycoplasma strains; Dr. Leach also for kindly supplying us with his G. D. L.-strain. We thank Dr. H. Cohen and Dr. A. C. Hekker for their criticism and Mr. N. L. M. van Zwetselaar for his accurate technical assistance.     

The use of temperature biofeedback in the treatment of chronic pain due to causalgia

A patient with chronic pain due to a reflex sympathetic dystrophy in his hand and arm was successfully treated with temperature biofeedback after several months of conservative standard medical care brought little relief. Over the 18 treatment sessions the patient learned to emit a reliable handwarming response of 1 to 1.5°C. Coincident with his learning, the pain in his hand and arm decreased markedly and remained absent at 1-year follow-up.The author wishes to acknowledge the assistance of Dr. Kit S. Mays and the staff of the Pain Clinic of the University of Tennessee Center for the Health Sciences.     

女性乳房血供及神经支配的应用解剖进展

乳房作为女性身体的一个重要器官,不仅具有孕育生命的作用,更是女性形体美最显著的标志。然而由于各种原因导致女性乳房的形态千差万别,这不仅严重影响了女性的形体美,而且会对女性带来各种轻重程度不等的身体不适,更严重者甚至会对女性的心理健康造成极大的影响。这就需要整形外科医生通过乳房整形手术重新塑造女性乳房的形态美。由于术后易发生皮瓣及乳头乳晕血供障碍、乳头乳晕区域支配神经的损伤以及乳房形态不佳,使得巨乳缩小整形术具有手术难度大,手术风险高,术后患者满意度较差的特点,成为乳房整形手术中的一大难点。究其原因,我们对于女性乳房的血供和神经支配,尤其是乳房内血管神经的具体走行和分支仍然未能了解得十分清晰。因此,开展乳房血供及神经支配的应用解剖研究,对于改良目前的乳房整形手术特别是巨乳缩小整形术术式,以降低手术相关并发症的发生率,具有及其重要的临床指导意义。本文主要从乳房的血供和神经支配两个方面,对乳房的应用解剖进展进行综述。     

Cellular signaling in PKD: foreword

This monograph is dedicated to the memory of Dr. Jared James Grantham (1936–2016), a wonderful man, a compassionate physician, a passionate researcher, and an exceptional scientist. Without his vision, achievements and impact on countless collaborators and disciples, the field of Polycystic Kidney Disease would not be where it is today. His intellect, tenacity, modesty and kindness continue to be an inspiration to all.     

Human Resource and Funding Constraints for Essential Surgery in District Hospitals in Africa: A Retrospective Cross-Sectional Survey

Background

There is a growing recognition that the provision of surgical services in low-income countries is inadequate to the need. While constrained health budgets and health worker shortages have been blamed for the low rates of surgery, there has been little empirical data on the providers of surgery and cost of surgical services in Africa. This study described the range of providers of surgical care and anesthesia and estimated the resources dedicated to surgery at district hospitals in three African countries.

Methods and Findings

We conducted a retrospective cross-sectional survey of data from eight district hospitals in Mozambique, Tanzania, and Uganda. There were no specialist surgeons or anesthetists in any of the hospitals. Most of the health workers were nurses (77.5%), followed by mid-level providers (MLPs) not trained to provide surgical care (7.8%), and MLPs trained to perform surgical procedures (3.8%). There were one to six medical doctors per hospital (4.2% of clinical staff). Most major surgical procedures were performed by doctors (54.6%), however over one-third (35.9%) were done by MLPs. Anesthesia was mainly provided by nurses (39.4%). Most of the hospital expenditure was related to staffing. Of the total operating costs, only 7% to 14% was allocated to surgical care, the majority of which was for obstetric surgery. These costs represent a per capita expenditure on surgery ranging from US$0.05 to US$0.14 between the eight hospitals.

Conclusion

African countries have adopted different policies to ensure the provision of surgical care in their respective district hospitals. Overall, the surgical output per capita was very low, reflecting low staffing ratios and limited expenditures for surgery. We found that most surgical and anesthesia services in the three countries in the study were provided by generalist doctors, MLPs, and nurses. Although more information is needed to estimate unmet need for surgery, increasing the funds allocated to surgery, and, in the absence of trained doctors and surgeons, formalizing the training of MLPs appears to be a pragmatic and cost-effective way to make basic surgical services available in underserved areas. Please see later in the article for the Editors'' Summary     

Ethanol stimulates phospholipid turnover and inositol 1,4,5-trisphosphate production in Chlamydomonas eugametos gametes

Alcohols induce mating-structure activation in Chlamydomonas eugametos gametes. From the effect of ethanol on the ³²P-labelling of polyphosphoinositides, we conclude that the synthesis of these lipids is stimulated. Biologically inactive concentrations of ethanol (<6%) had no effect on synthesis, but 6–8% ethanol stimulated synthesis for upto 60 min. The ³²P incorporated into polyphosphoinositides and phosphatidic acid during ethanol treatment was readily chased out when 1 mM unlabelled Na₃PO₄ was added. Using a binding assay for inositol 1,4,5-trisphosphate, we show that the production of this phospholipid constituent is dramatically increased after ethanol treatment. This effect, coupled to a rise in intracellular calcium concentration, could explain gamete activation. The significance of these results in explaining other ethanol-induced phenomena in algae is discussed.Abbreviations Ins(1,4,5)P₃ inositol 1,4,5-trisphosphate - PtdA phosphatidic acid - PtdIns phosphatidylinositol - PtdIns(4)P phosphatidylinositol 4-phosphate - PtdIns(4,5)P₂ phosphatidylinositol 4,5-bisphosphate To whom correspondence should be addressedWe thank Dr. P. van Haastert (Biochemistry, University of Groningen, The Netherlands) and his colleagues for introducing us to their Ins(1,4,5)P₃ assay, and Ben ten Brink (Molecular Cell Biology, University of Amsterdam, The Netherlands) for information about contractile vacuoles. We also thank Bas Nagelkerken, Marcel van der Vaart, Pieter van der Schoor, Gyuri Fenyvesi and Susan Kenter for their help.     

Review: Natural Antimalarial Agents (1995-2001)

Malaria is one of the diseases for which even today not many suitable drugs are available. The rapid spread of resistance toward current drugs encourages the study for new active molecules. Ethnobotanical research can be of help to find new leads. Traditional remedies have always been a source of important antimalarial drugs and continue to provide novel and effective treatments, both where pharmaceuticals are not available and also where the disease is highly resistant to commonly prescribed drugs. This article provides a comparative compilation of various studies reported between 1995 and 2001 on natural compounds with antiplasmodial activity, with the goal of providing a basis for further in vitro and in vivo studies, as well as for clinical trials for the development of new antimalarial medicines. Referee: Dr. Robert Verpoorte, Leiden/Amsterdam Center for Drug Research, Gorlaeus Laboratories, Leiden University, Einsteinweg 55, PO Box 9502, 2300 RA Leiden, The Netherlands