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PubMed1978

[Remarks on the international histological nomenclature].

An analysis of the international Histological Nomenclature (Nomina Histologica 1970 and 1975 revision) shows that its latin terms are of an heterogeneous origin and of non-uniform value. Some understanding of the difficulties met with its practical use, is to be obtained in this way. The suggestion is offered that, while retaining the latin nomenclature as the international standard, the establishment of two english and french official versions would be very useful and a valuable means of spreading the knowledge of the international nomenclature. The rejection of eponyms is presently less rigid than before, which is in accordance with settled habits and may contribute to improve the precision, and sometimes the conciseness, of certain latin terms of the Nomina HIstologica. The opportunity for the inclusion of a number of terms of interest for veterinary histologists, another feature of the 1975 revision, seems to be questionable.

Histology↗
PubMed1995

Injury surveillance at the USTA Boys' Tennis Championships: a 6-yr study.

Injuries that required physical or medical assistance were recorded for participants at the United States Tennis Association National Boys' Tennis Championships from 1986-1988, 1990-1992 (N = 1440, 240 athletes per year). Over the 6-yr period, a total of 304 athletes (or 21.1%) sustained new or recurrent injuries that required evaluation by the medical team. New injuries alone numbered 145 (incidence rate of 9.9 per 100 athletes). The analysis of injuries showed a higher rate of lower than upper extremity injuries. When evaluated by anatomic regions, back injuries were most common followed by thigh, shoulder, and ankle injuries, respectively. When evaluated by injury type, strains and sprains were most common (71% of all injuries) with fractures and dislocations being rare (1.3% of all injuries). The lower extremity provided the majority of sprain type injuries with 87.5% of ligament sprains coming from the knee and ankle. Injuries with tennis eponyms (i.e., tennis toe, tennis leg, tennis elbow, and tennis shoulder) were rare (0%-5% of all injuries). It would appear that these young elite athletes are at significant risk of injury.

Adolescent↗
PubMed1995

The Trendelenburg position: a review of current slants about head down tilt.

The steep head down tilt surgical posture, popularized in the 1870s by Trendelenburg as a means of improving access to pelvic pathology and espoused by the American physiologist, Walter Cannon, during World War I as a resuscitative position with which to treat shock, has a history of widespread, ritualistic acceptance. An awake patient placed in steep head down tilt usually objects to the posture after only a short time. Now recognized as potentially harmful in the presence of cardiac, pulmonary, ocular, and central nervous system pathology and essentially useless for vascular resuscitation, steep tilt should be limited to selected circumstances in which alternatives are unacceptable. Shallow head down tilt, a more recent variety, also offers serious questions about its surgical usefulness as well as its applicability for patients with diseased hearts, lungs, and heads. As an aid to resuscitative procedures, the contoured supine position offers assets that merit serious consideration. Means of restraining a tilted patient on an operating table include wristlets, shoulder braces, and bent knees with ankle restraints. Considerations that aid in the selection of head down tilt are presented, as is a plea for the abandonment of the Trendelenburg eponym and a suggestion for future investigation.

Head-Down Tilt↗
PubMed1994

Barrett's esophagus.

Barrett's esophagus is the condition wherein columnar epithelium replaces squamous epithelium in the esophagus. The condition is named for the late Mr Normal Barrett, an English surgeon whose most renowned publication, ironically, is a treatise contending that the esophagus cannot be lined by columnar epithelium. The eponym is used commonly despite Mr Barrett's mistaken contention, although some European authors still prefer to call the condition "endobrachyesophagus." Barrett's esophagus appears to be a sequela of gastroesophageal reflux disease (GERD), and it is the major known risk factor for esophageal adenocarcinoma. Barrett's esophagus is usually discovered during endoscopic evaluation of patients who have symptoms caused by GERD or esophageal cancer. Consequently, data on the clinical features of Barrett's esophagus are derived primarily from studies on symptomatic patients in whom the condition was recognized endoscopically. Recent investigations suggest that more than 90% of cases of Barrett's esophagus in the general population are not recognized by physicians, and many of these unrecognized patients have few or no symptoms of GERD. It is important to appreciate, therefore, that conclusions drawn from studies on patients with clinically apparent disease are not necessarily applicable to the "silent majority" of individuals with Barrett's esophagus.

Adenocarcinoma↗
PubMed1994

[Li-Fraumeni syndrome and germ-line mutations of the p53 gene].

The eponym Li-Fraumeni syndrome is given to a particular form of cancer-prone family in which the main encountered tumors are sarcomas occurring in childhood and breast cancers affecting young adult females. There is also an increased frequency of cerebral tumors, leukemias and adrenal carcinomas among these families. The transmission of the cancer-proneness is autosomal dominant and related to the loss of function of the p53 tumor suppressor gene located on the short arm of the chromosome 17. The related p53 protein is identified but its precise mechanism of action and its regulation are still unclear. It seems to activate the genes which negatively regulate the multiplication of the cell and to act as a factor of transcription. A germline mutation of the p53 gene must be looked for in every cancer-prone family but also in case of multifocal tumors, particularly osteosarcomas and glioblastomas, and in case of second malignant neoplasm. This is of major scientific as well clinical interest. Indeed, the study of new families will help to better understand the molecular mechanisms underlying the syndrome. For the family itself this allow to identify the cancer prone members and to offer them preventive measures and early detection of cancers, particularly early breast cancer detection.

Child↗
PubMed1994

[Vascular dementias].

The recent development of neuro-imaging technology has altered the classic anatomo-clinical pattern of vascular dementias (VD). However, few correlative studies have emerged and the creation of new eponyms--such as the successful "leuko-araiosis"--did not raise new highlights on the mechanisms involved in VD. The different clinical and radiological aspects of VD are briefly reviewed and the contribution of CT-scan and MRI are discussed.

Aged↗
PubMed1993

Unpublished letters from Prosper Menière: a personal silhouette.

It is ironic that, while the term "Menière's disease" is becoming more and more well known today, published accounts of a biographic nature are scarce for the man for whom the eponym was devised: Prosper Menière. As we are obliged to turn to only a few avenues for this sort of information, we are fortunate to discover new sources of original materials to augment the published account of the life and character of Menière the man. One such unpublished source that has recently come to light is a cache of letters from the pen of Menière that was preserved for the period extending from the early 1850s up to the time shortly preceding the author's death a decade later; and it is these letters that form the basis of this inquiry into the mind and character of Menière, the brilliant otologist and man of letters. This particular body of letters, while being for the most part of an admittedly social nature, is of particular interest not only for the occasional references Menière makes to the ear or to his deaf-mute patients, but also because of Menière's epistolary style, and because of their content in general. For this reason the letters have been analyzed primarily with an eye to three categories of interest. The first category is the professional life of Menière, which for the purpose of this paper will be understood to comprise his professional work as a physician, his mention of his patients, of deaf-mutes and their treatment, of his writings in general, and of other pertinent aspects of his medical involvement.(ABSTRACT TRUNCATED AT 250 WORDS)

Correspondence as Topic↗
PubMed1993

[Cesar Roux and his Roux-en-Y anastomosis].

During the last 100 years, since Cesar Roux (1857-1934) began utilizing his "Loop-en-Y" procedure for gastric outlet obstruction, this technique fell into disfavour but later, with the vagotomy, it was adapted for multiple applications. The greatest factor in its revival has been the treatment of postgastrectomy sequels, including alkaline reflux gastritis, reflux esophagitis, dumping and other syndromes. Additionally Roux-en-Y anastomosis has been used to drain diverse organs as the biliary tract, pancreas and esophagus. The main complication of loop-en-Y is the Roux syndrome, secondary to gastric or efferent jejunal stasis, or both. As the centennial of Roux's first use of his eponymic procedure approaches its seems appropriated to remind its memory as a part of our surgical inheritance.

Afferent Loop Syndrome↗
PubMed1993

Differential diagnosis in congenital vascular-bone syndromes.

Congenital vascular-bone syndrome is an alteration in limb growth caused by congenital vascular malformations in childhood. A precise study of the anatomic and hemodynamic nature of the underlying defect is necessary, not only for diagnosis, but also for therapy. The use of old eponyms for diagnosis, such as "Klippel-Trenaunay," "Parkes-Weber," and "Servelle-Martorell" should be abandoned because they are meaningless and misleading. An anatomic/pathological categorization, according to the simple "Hamburg classification," is more practical for clinical purposes. Seven different types of vascular defects, all associated with a-v fistulas, are related with limb overgrowth. Four different types of vascular malformations may produce limb shortening. Complete diagnostic study should allow classifying the malformation into one of the groups listed and illustrated above. Precise diagnosis is useful because interventional therapy can correct limb length discrepancy if performed before epiphyseal closure.

Adolescent↗
PubMed1993

The Whipples and their legacies in medicine.

George Whipple and Allen Whipple lived as contemporaries, but were not related. Their careers have many similarities. Both had the best available education and training. Both achieved distinction as administrator, educator and researcher. George Whipple founded the medical school at University of Rochester and was its first Dean for 32 years. Allen Whipple established a modern department of surgery at Columbia University and held the chair in surgery for 25 years. Both Whipples were published extensively and did extensive work on the gastrointestinal system. George Whipple's elucidation of the effect of liver on hemoglobin formation won for him a Nobel Prize. The work of Allen Whipple on the pancreas earned him the title of father of modern pancreatic surgical treatment. He also revitalized the surgical management of portal hypertension. Both Whipples were remembered with eponyms--George Whipple for his report on a small intestinal disease and Allen Whipple for his triad and operation. Both achieved international reputations and represented the finest embodiments of American medicine.

Education, Medical↗
PubMed1977

[Foix-Chavany's syndrome: clinical and electrophysiological study of 1 atypical case (author's transl)].

An atypical case of "Foix-Chavany syndrome", is described. A definite diagnosis could be achieved through an electromyographic and reflessological investigation (jaw reflex, blink reflex, perioral reflex), when a poor clinical history was not helping towards a definite diagnostic conclusion. It is proposed that the diagnosis of "Foix-Chavany syndrome" should not be limited only to classical "facial diplegia of cortical origin" or to "facio-linguo-pharyngo-laryngo-masseter paralysis of cortico-subcortical origin". Considering the great clinical variability of a syndrome with a common anatomical substrate, it is proposed to use the eponym for all syndromes characterized by: 1) a motor deficit in the cephalic district with relative integrity of motor function of the limbs; 2) a dissociation between loss of voluntary motility and preservation of reflex and automatic motility.

Deglutition Disorders↗
PubMed1995

Marjolin's ulcer due to venous stasis.

The eponym Marjolin's ulcer is used to describe the malignant transformation of any benign ulcer or scar. The most common association is with burn scars, with the cancer occurring thirty years after the original injury. Venous stasis has been a rarely reported cause of this phenomenon. This case demonstrates such a finding, stressing the aggressive nature of these carcinomas, and therefore the need to examine a biopsy specimen when a benign ulcer presents with an atypical appearance.

Biopsy↗
PubMed1977

Ebstein's anomaly: a report of 3 cases in the dog.

Three young unrelated dogs were diagnosed as having the canine counterpart of Ebstein's anomaly, an eponymic term for a cardiac malformation in man. All of the dogs had systolic murmurs in the tricuspid area, and all had radiographic evidence of cardiac enlargement, particularly of the right atrium. Electrocardiography indicated atrial disease or right atrial enlargement and right ventricular conduction defects. The defect was confirmed by means of cardiac catheterization in all 3 dogs. Open heart surgery was performed on 2 of the dogs--plastic reconstruction of the tricuspid annulus and placement of a prosthetic valve in 1 and closure of an atrial septal defect in the other; both of these dogs died (1 day and 1 month after surgery).

Animals↗
PubMedDate not supplied

A history of immunosuppressive drugs in the treatment of inflammatory bowel disease: origins at the Mount Sinai Hospital.

If the cause of Crohn's disease and ulcerative colitis turns out to be some immunopathologic mechanism, many of the steps leading to such an understanding of their pathogenesis can be attributed to concepts that originated at The Mount Sinai Hospital. Perhaps immodestly, we can claim a role in the acceleration and the acceptance of these concepts; however, many contributions were made by others, including Moschkowitz, Klemperer, Otani, Crohn, Ginzburg, Oppenheimer, Marshak, and Janowitz. This does not mean that clinicians and researchers from other institutions did not contribute to this understanding. As happens so often in medical history, elucidation of many disease processes are serendipitous. The concept of autoimmune diseases was introduced when we were house officers at Mount Sinai. The early days of transplant surgery soon followed along with the introduction by Hitchings and Elion of azathioprine to inhibit rejection. The concept of immunosuppression slowly evolved into possible treatment of any disease thought to be caused by autoimmunity, including those diseases of the bowel, seen so frequently at The Mount Sinai Hospital: ileitis, granulomatous colitis, ileocolitis, and ulcerative colitis. Although most of the world called granulomatous disease of the bowel Crohn's disease, it was only after the deaths of Drs. Crohn, Ginzburg, and Oppenheimer that we accepted this single eponym. However, we will always pay tribute to all three Mount Sinai physicians who wrote the original paper that described the disease.

Azathioprine↗
PubMed1996

[Youthful sudden cardiac death and the Kawasaki syndrome. An anatomopathological case report].

In 1967 Kawasaki studied 50 cases with the same features as mucocutaneous lymph node syndrome, further reported throughout Japan with the eponym of Kawasaki's disease. It is frequent in Japan and in USA, whereas in Europe it is sporadic and often misinterpreted. It presents as an acute fever, attended by irritation of the skin and oral mucosa, with swelling of cervical lymph nodes, easily misdiagnosed as scarlet fever, Stevens Johnson syndrome, or infantile exanthema or allergy. After the acute phase, Kawasaki's disease becomes chronic and sudden death is possible even if many years have elapsed. In the chronic phase, coronaritis, coronary aneurysms, marked stenosis and/or occlusive thrombosis are often present. Cardiac Lesions were classified from stage I to IV according to the duration of illness at death. The present work deals with the case of a 17 year old man, dying from undiagnosed coronary artery chronic Kawasaki disease. The patient had been hospitalized for Wolff-Parkinson-white syndrome; ten months after discharge he died suddenly, while performing gymnastics at school. Occluding thrombosis of cylindrical aneurysm of both coronary arteries, from undiagnosed Kawasaki arteritis, was found and the young boy succumbed to hyperacute infarction. The heart was fixed in buffered formalin 10% and embedded in paraffin. Histological examination of the cardiac conduction system has been carried out on serial sections, with the technique usually adopted by one of the present authors (L. Rossi). Hema-toxylin-eosin (H-E) and trichromic (Hei-denhein-azan) stainings have routinely employed.

Adolescent↗
PubMed1996

Glaucoma with inflammatory precipitates on the trabecular meshwork: a report of Grant's syndrome with ultrasound biomicroscopy of precipitates.

BACKGROUND: The syndrome of inflammatory precipitates on the trabecular meshwork is a rare form of inflammatory glaucoma that was described by Chandler and Grant in 1968 and subsequently given the eponym Grant's syndrome. METHODS: We present two cases of elevated intraocular pressure associated with inflammatory precipitates on the trabecular meshwork in otherwise relatively quiet eyes, consistent with Grant's syndrome. We review the epidemiology, clinical features, and mechanism of this syndrome. In addition, we demonstrate the use of ultrasound biomicroscopy for imaging angle inflammatory precipitates. RESULTS: Our patients demonstrate the cardinal features of Grant's syndrome, including acute onset, significant elevation of tension, trabecular meshwork precipitates in an otherwise quiet eye, limited response to typical pressure lowering agents, excellent response to topical steroids, evidence of recurrence with bilaterality, and systemic association with sarcoidosis. Ultrasound biomicroscopy proves to be a useful adjunct for pathologic imaging. CONCLUSIONS: The syndrome of glaucoma with inflammatory precipitates on the trabecular meshwork is a rare entity that should be considered as a possible diagnosis of elevated intraocular pressures in otherwise apparently quiet eyes.

Female↗
PubMed1996

[Squamous cell carcinoma in neuropathic plantar ulcers in leprosy: another example of Marjolin's ulcer].

Seven cases of squamous cell carcinoma (SCC) arising in chronic neuropathic plantar ulcers of leprosy are described. These patients (average age 59 years) presented over a 5-year period. The mean duration of neuropathic ulceration until diagnosis of SCC was 24.5 years. Six patients required limb amputations and 3 underwent lymphadenectomy for involved nodes. One patient died of disseminated disease. The history of the eponym "Marjolin's ulcer' is traced and a case put forward for recognition of malignant change in neuropathic ulcers as yet another example of Marjolin's ulcer. A plea is made for an increased awareness of the possibility of malignant transformation in chronic neuropathic ulcers in order to effect an early diagnosis of a potentially aggressive cancer. This is the first report of its kind in South Africa. Similar cases, however, have been reported from other parts of the world where leprosy is endemic.

Aged↗
PubMed1996

Recognizing Weber-Christian disease.

The eponym Weber-Christian Disease (WCD) defines a chronic disorder characterized by relapsing febrile episodes and panniculitis. Systemic manifestations due to visceral involvement may be present. WCD is associated with no identifiable cause, although chronic panniculitis may be due to definable underlying disorders. A variety of distinctive disease entities, such as systemic lupus erythematosus (SLE), pancreatic disease, alpha-I-antitrypsin disease, lymphoproliferative neoplasia, infections, or trauma are associated with chronic panniculitis. The accurate diagnosis of panniculitis requires an adequate deep skin biopsy showing inflammation of the subcutaneous layers. We describe a white woman with fever and recurrent episodes of painful nodules of the lower extremities, excisional biopsy of which confirmed panniculitis. The febrile episodes and skin lesions responded dramatically with the use of oral corticosteroids.

Adrenal Cortex Hormones↗