Visualizzazione post con etichetta History. Mostra tutti i post
Visualizzazione post con etichetta History. Mostra tutti i post

domenica 22 dicembre 2013

Landmarks in history of cancer

Una serie di articoli che descrive la storia del cancro in rapporto all' evoluzione delle conoscenze mediche.
Una lettura interessante, durante le ferie natalizie.

Bibliografia:


A large scapulohumeral tumor, most likely a sarcoma, was illustrated by Severino in his book, De Recondita, published in 1632. This the first clinical illustration of a tumor.
Hajdu SI. A note from history: landmarks in history of cancer, part 2

lunedì 23 settembre 2013

Vessels of Stone: Lenin's "Circulatory Disturbance of the Brain"

Many have wondered what might have become of the totalitarian state Lenin founded on merciless terror, had he not died so young. He was 52 and at the height of his power when he had his first stroke. Six months later he had another and then a third stroke three months after that. He died 3 months shy of his 54th birthday with cerebral arteries so calcified that when tapped with tweezers at the time of his autopsy, they sounded like stone. The reason for his premature atherosclerosis has yet to be explained. He had a family history of cardiovascular disease and, therefore, is suspected of having had an inherited lipid disorder. Stress too might have had a role in the progression of his atherosclerosis. However, neither would explain the extent of the calcification of his cerebral arteries identified at post mortem examination. A recently described variant of the NT5E mutation might explain such calcification, as well as Lenin's family history of cardiovascular disease, and his premature cerebrovascular attacks.
Vinters H, Lurie L, Mackowiak PA. Vessels of Stone: Lenin's "Circulatory Disturbance of the Brain". Hum Pathol. 2013 Feb 18.

On the morning of January 23, 1924, the pathologist Alexei Ivanovich Abrikosov was given a task to embalm Lenin's body to keep it intact until the burial. The body is still on permanent display in the Lenin Mausoleum in Moscow. (source Wikipedia)

(to note, Abrikosov has also described the so-called Abrikosov's tumor aka Granular cell tumor)

lunedì 26 agosto 2013

Lepidic, a Canadian Neologism

In the new classification of adenocarcinomas, the term lepidic is defined as tumor cells proliferating along the surface of intact alveolar walls without stromal or vascular invasion.
[...] This word is a neologism, a new word invented in Canada in the early 1900s [by] John George Adami, MD. [...] After studying in Manchester, Cambridge, Breslau, and Paris, Dr Adami arrived at McGill University in Montreal, Canada, in 1892. Adami was a prolific writer, and he first used the term lepidic in an address to the Toronto Pathological Society on January 4, 1902. In his lecture titled ‘‘Original Communication on the Classification of Tumors,’’ he proposed 2 new terms that would be used to classify all neoplasms. The term lepidic (from greek meaning a rind, skin, or membrane) was applied to tumors that appeared to be derived from surface-lining cells. The term hylic (from greek meaning crude undifferentiated material) was applied to tumors that appeared to be derived from connective tissues. [...]
[...] The terms lepidic and hylic underwent a subtle change in meaning. In Herbert Spencer’s Pathology of the Lung,6 published in 1962, he stated that tumors may grow into the surrounding alveoli ‘‘either filling them with a solid mass of malignant cells (a hilic [sic] growth) or lining their walls (a lepidic growth).’’ This is a minor alteration in definition; however, this is where the modern definition of tumor growth along intact alveolar septa arose. [...]
In the early 1990s the erroneous belief that the term lepidic came from the etymologic origin ‘‘butterfly’’ became prevalent. [...] Soon the term was stated to mean, ‘‘like a butterfly resting on a branch,’’ ‘‘resembling butterflies sitting on a fence,’’  ‘‘butterflies alighting on shrubbery,’’ ‘‘vague resemblance in cross-section to a butterfly,’’ and a reference ‘‘to the scales of the butterfly wing.’’  While these colorful and useful metaphors evoked both the microscopic morphologic appearance and the possible aerogenous mode of dissemination, they were unrelated to the source of the term. Lepidic did not have an entomologic etymology.

John George Adami (left) first chair of pathology at McGill University (Montreal, Canada) and creator of the term lepidic. Lepidic pattern of adenocarcinoma, characterized by noninvasive surface alveolar growth of tumor cells (right).

Jones KD. Whence Lepidic? Arch Pathol Lab Med. 2013 Aug 12. 

(seen on http://timallenmdjd.blogspot.it/ via Twitter)

domenica 28 luglio 2013

Thomas Hodgkin: the “man” and “his disease”

Thomas Hodgkin (1798–1865) was one of the leading physicians and scientists of the nineteenth century. His outstanding contributions transcend many fields, medical and non-medical. A renowned diagnostician, he carried out pioneering work in public health and epidemiology, but devoted the greater part of his career to the study of pathology. Among his many interests were anthropology, geology, geography, and ethnography. He helped found the University of London. [...] His most important legacy to medical science was the recognition of the condition called “Hodgkin’s disease,” now known as “Hodgkin lymphoma”. Hodgkin did not fully appreciate the importance of this work and, indeed, it was not recalled as being a particularly noteworthy contribution at the time of his death.

 A un anno dal seminario del prof. Pettinato, posto un recente paper che prende in esame la vita di Thomas Hodgkin e la storia della patologia che da lui ha preso il nome.

Geller SA, Taylor CR. Thomas Hodgkin: the "man" and "his disease": humani nihil a se alienum putabit (nothing human was foreign to him). Virchows Arch. 2013 Jul 26.

a A specimen from the Gordon Museum, Guy’s Hospital of one of the original Hodgkin lymphoma cases described by Hodgkin.








b Water-color drawing by Robert Carswell of case VII . Both images show well the discrete abnormal nodes in contrast to the usual picture of non-Hodgkin lymphoma where nodes are matted together 
(da Geller et al, 2013)

lunedì 3 giugno 2013

A brief chronicle of clinical cytology

Posto un breve excursus sulla storia della citologia clinica apparso recentemente su Diagnostic Cytopathology. Per chi volesse approfondire l' argomento, consiglio l' ottimo libro di Grunze e Spriggs corredato da uno splendido apparato iconografico.

Hampeln, in 1887, published the first case of primary squamous cell carcinoma of the lung and pleura with an illustration of a drawing of cancer cells

(Hampeln P. Über einen Fall von primären Lungen-Pleura-Carinom. St. Petersburg med Wohenschr 1887; 12: 137.)
















Bibliografia.


Grunze, H. and A. I. Spriggs (1983). History of clinical cytology: a selection of documents, G-I-T Verlag E. Giebeler.

martedì 29 gennaio 2013

Surgical Pathology Snapshot #10: a 1.600 years old woman



Woman, aged 30-40 at the time of the death.

What's your diagnosis?


domenica 20 gennaio 2013

Dissection: a rite of passage

La pratica settoria su cadavere è stata per molto tempo fondamentale negli studi di medicina. Come è accaduto per i riscontri diagnostici, anche la pratica anatomica ha risentito dei tempi attuali, dove  le ricostruzioni digitali hanno via via eliminato la necessità di disporre concretamente di materiale cadaverico. Ma c'era un tempo in cui il corso di anatomia rappresentava un rito di passaggio, che i giovani studenti americani immortalavano all' alba dell' era fotografica. Quei giovani studenti con abiti antiquati, morti anch' essi come i loro soggetti di studio, ci osservano intorno ai cadaveri su cui facevano pratica di anatomia. Era un' epoca ai confini della morale e della legge, dove i cosiddetti resurresionists (i body snatchers di cui abbiamo visto le gesta romanzate nel primo cineforum) rifornivano le scuole di medicina con cadaveri per lo più di condannati, poveri ed afro-americani. La segregazione razziale continuava anche dopo la morte, ed in numerose fotografie si possono osservare futuri medici, prevalentemente bianchi, sezionare cadaveri, prevalentemente neri. Al Museum of London e' in corso  una mostra sul recente ritrovamento,  nel cimitero del Royal London Hospital, di numerosi scheletri risalenti a fine '800 con evidenti segni di pratiche settorie, testimonianza archeologica dell' attività dei resurresionists e della loro intima relazione con le scuole di medicina e chirurgia.  Fra le memorie italiane di questo "rito di passaggio", l' unica che ricordo è quella del poeta Salvatore di Giacomo, un' esperienza terribile che, fortunatamente per noi, lo ha strappato agli studi di medicina. Ecco di seguito la sua testimonianza autobiografica apparsa nell' Occhialetto di Napoli nel 1886:
Nello scorcio d’un malinconico ottobre, una mattina, tra le otto e le nove, mi avviavo  lentamente alla lezione d’anatomia, su per le scale di Sant’Aniello a Caponapoli. Pioviccicava; era una pioggerella diaccia e sottile che penetrava le ossa, una di quelle tristezze lagrimose con cui il cielo diventato grigio principia a piangere l’estate che se ne va. La scala era deserta e muta; [...]. Con le mani in saccoccia, il sigaro inumidito tra le labbra, soffrendo orribilmente a cagione d’uno stivalino troppo stretto, io salivo quel calvario dei miei diciott’ anni e pigliavo per l’ anfiteatro anatomico, col buon volere che avrebbe mosso un condannato a far la via del patibolo. Non so bene se ancora esista  quell' indegna cantina della morte, dove i cadaveri degli Incurabili si sciorinavano in tutta la miseria delle loro carni. [...]. I morti arrivati di fresco dormono in quella stanzetta a man destra, nudi, stesi supini, in una sacrilega confusione di sesso. [...]. Mettete l’ occhio all' inferriata d’un finestrino; ecco là, sulla panca bruttata di sangue, un cadavere giovanile, con le braccia penzoloni, la testa rasa, rovesciata. [...] Se avete coraggio, spingete ancora un usciolino in fondo: questa che segue è la bottega delle ossa; gli studenti vi possono comperare un paio di stinchi, un lucido cranio, una mandibola, una rotella, l’ umano bambù d 'una spina dorsale..
   Non so come, non so perché io scesi, in quella mattina, assalito da un indefinibile presentimento, la scala del deposito. Entrai, di mala voglia, nella sala in cui il professore anatomizzava, e mi posi in mezzo ai compagni miei, che guardavano, con attenzione grande  il cadavere d'un vecchio. Poco prima, seppi, uno di loro s'era svenuto. Era un novizio, un abruzzese, gentile e non forte. Ma come il professore aveva conciato quel vecchio morto!... [...]. Al meglio della lezione, uscii dalla sala. Non ne potevo più; mi si rivoltava lo stomaco. Senza guardarmi attorno, senza salutare nessuno, infilai il corridoio e feci per ascendere, in fretta e furia, la scaletta. In cima un bidello si preparava a discendere, con in capo una tinozza di membra umane. I gradini della scaletta, su per i quali erano passate centinaia di scarpe goccianti, parevano insaponati. Il bidello scivolò, la tinozza - Dio mio! - la tinozza rovesciata sparse per la scala il suo contenuto, e, in un attimo, tre o quattro teste mazze, inseguite da gambe sanguinanti, saltarono per la scala fino a' miei piedi! Di sopra il bidello urlava e sacramentava, raggomitolato in un angolo, aferrandosi una gamba lussata...
Quell’ inserviente, dalla faccia butterata e cinico, dall’ aria insolente, dalla voce sempre rauca, com' egli era sempre oscenamente avvinazzato, si chiamava Ferdinando. Per la faccia sua, cincischiata a quel modo, i compagni lo chiamavano, napoletanamente, Setaccio. lo devo la mia salvazione a Setaccio, perché da quel giorno la cantina dei cadaveri non mi vide più e nemmanco l’ Università, dove compivo il terzo anno di medicina.
Dissection at the Yale School of Medicine around 1910. From the book Dissection.


Bibliografia:

domenica 22 luglio 2012

Teaching anatomy to our great-grandparents

POP-UP MEDICINE A life-size cardboard manikin that students used. 
The 175-year-old National Library of Medicine in Bethesda, Md., is best known these days for its PubMed database, the pre-eminent digital catalog of the biomedical literature. But like many digital giants, the library has its dusty analog past — otherwise known as a closet full of stuff. 

[...] (in 19th century) American students could flip open dozens of doors on a life-size cardboard manikin and pretend to dissect or, if they preferred, to operate. Opening still other doors illuminated the disastrous effects of alcohol, narcotics and tight corsets on the human body. 
Da Zuger A,  Art and Artistry of Our Anatomy.








Bibliografia: 


Sappol M, Svenson A, Lindgren L, Hidden Treasure: The National Library of Medicine  Blast Books (2012)

domenica 28 agosto 2011

Stout's guide to writing a scientific paper.

Da The autobiography  of Arthur Purdy Stout (Notes on the education of an "oncological" surgical pathologist) in Guiding the Surgeon's Hand, Rosai J, 1997. (p 252-253)

I first collect all the data necessary for the subject and review the literature by abstracting each paper I read [...] . My articles always consist of an  introduction  that tells the whys and wherefores and a historical review [...];  next comes an account of the data reported, including case histories; then a commentary on these pointing out subjects to be stressed, new interpretations, reasons for agreeing or differing with the conclusions of others; and finally a summary [...] I always striven for lucidity and simplicity of expression and have eschewed redundancy. [...] When collaborating with young resident  and others, I have had to struggle to make them cut out redundant material and stick to the essential. [...]  it has never disturbed me to confess to an error, although I have noticed  that others  find this hard to do . If these people have to change an opinion the tendency seems to be ignore their former publication [...]

Bibliografia:

Biografia di Arthur Purdy Stout  (Wikipedia )


Audisio RA, Stahel RA, Aapro MS, Costa A, Pandey M, Pavlidis N. Successful publishing: how to get your paper accepted. Surg Oncol. 2009 Dec;18(4):350-6.