San Marino stamps up St. Apollonia in style.
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It is universally acknowledged that if cancer is to be controlled, prevention and down staging are essential. In the year 2000 about 10 million new cases were registered, while 6.3 million people died from cancer worldwide. Stamps are regarded as a very useful and educative tool in fighting cancer by creating awareness and raising money for treatment and research. This year (2003) is the seventy-fifth anniversary of the issue of the first anticancer stamps in 1928, so an up-to-date review of the field of oncophilately is timely.
The world's nations issue postage stamps with themes that their governments regard as being of significant national and international importance. The philatelic record, thus, parallels each nation's history, its themes of contemporary pride and its aspirations for the future. As children's health is one of the most important of all issues of public and political life, it is not surprising that paediatricians are permanently commemorated in many of the world's postage stamps. Hippocrates is portrayed on many of the world's stamps, as are children's illnesses and children's doctors. Paediatricians are portrayed on stamps from New Zealand, Papua New Guinea, Australia, the United States of America, the nations of Africa, Europe and the United Nations. Themes permanently recorded in the philatelic record encompass every discipline within paediatrics, including portraits of Dr Virginia Apgar (of the Apgar score), Dr Truby King (New Zealand) who was responsible for the introduction of universal postnatal nursing visits for every child, and Dr Janusz Korczak (1879-1942), the Polish paediatrician who gave his life at Treblinka in World War II in order that his child patients might not die alone. The paediatric philatelic record is thus an international repository of the chronology of child care.
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The introduction of curare into clinical anaesthesia by Griffith and Johnson in 1942 contributed to the termination of the era where anaesthesia was a reversible intoxication rather than the result of controlled drug action. Curare allowed general anaesthesia to be reduced to a lighter level, thereby conferring a significant safety factor to the patient. Both the shortage in supply of crude curare and its variable composition led the search for synthetic curare analogues conferring well defined pharmacodynamic and pharmacokinetic properties. Based on the chemical structure of tubocurarine which has been known since 1935 the efforts concentrated on bisquaternary ammonium compounds. Gallamine was the only synthetic curare analogue to contain three quaternary ammonium groups. This drug had significant undesired vagolytic effects. In 1951 succinylbischoline appeared to be the ideal muscle relaxant, particularly with respect to its fast onset and short duration of action. The disadvantages of its depolarising mechanism of action which were appreciated during the years to follow prevented the concept of depolarising neuromuscular blockade to be pursued further. With other muscle relaxants, including curare itself, histamine release, vagal blockade and ganglionic blockade were undesired effects to be eliminated in future compounds. Improved understanding of structure-activity relationships turned out to be an indispensable tool for future research. This in turn required more elaborate methods in chemical analysis, in electrophysiology of the motor endplate, and in ultrastructural research. As a result, alcuronium and pancuronium became available in the late sixties and early seventies. Both muscle relaxants had a non-depolarising mechanism of action with reduced side effects relative to curare. From now on better techniques for pharmacodynamic and pharmacokinetic research became available resulting in research activity with particular emphasis in this field. Researchers became aware that new muscle relaxants should be designed for larger volumes of distribution and more rapid biodegradation than those currently available. Concurrently, anaesthesia techniques had changed in a way to use intubation and mechanical ventilation as a routine procedure. The risk of intraoperative hypoventilation and hypoxemia was eliminated, yet, due to the lack of adequate monitoring techniques the slow recovery from curare, alcuronium or pancuronium neuromuscular blockade was hardly appreciated.(ABSTRACT TRUNCATED AT 400 WORDS)
An attempt should be made to summarize the history of ophthalmology in a small series of postage stamps. Eighteen stamps could be dedicated to themes recalling the achievements of famous ophthalmologists. In this way it would be possible to acquaint the public with some medical history while at the same time encouraging an interesting leisure pastime.
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