The differential effect of pentoxifylline on cytokine production by alveolar macrophages and its clinical implications

The aim of this study was to investigate the effects of pentoxifylline (PTX) on the production of TNF-alpha, IL-1 beta, IL-6 and GM-CSF by lipopolysaccharide (LPS)-stimulated alveolar macrophages (AM). AM and peripheral blood monocytes (PBM) from 10 patients were cultured for 24 h in the presence of LPS (10 micrograms ml-1) and PTX at concentrations of 2.0 mM, 1.0 mM, 0.5 mM, 0.1 mM and 0.01 mM. TNF-alpha and GM-CSF were measured from the culture supernatants of both the AM and PBM from all 10 patients and IL-1 beta and IL-6 from the culture supernatants of the AM from five patients. The TNF-alpha production by AM was significantly suppressed in the presence of PTX at concentrations of 2.0 and 1.0 mM, while production of IL-1 beta, IL-6 and GM-CSF remained unaffected. In PBM cultures, PTX significantly suppressed the production of TNF-alpha and GM-CSF, at all tested concentrations. The present study provides evidence that PTX selectively suppresses the production of TNF-alpha by LPS-stimulated AM and may have a role in the treatment of lung diseases where TNF-alpha is involved. The mode of administration of PTX should take into account the suppressive effect of this drug on GM-CSF production by PBM.

p16 inactivation associated with aggressive clinical course and fatal outcome in TEL/AML1-positive acute lymphoblastic leukemia

The authors describe a 7-year-old boy with TEL/AML1-positive pre-B acute lymphoblastic leukemia, with hemizygous 9p21 deletion at presentation and no p16(INK4A) protein expression. Despite an initial response to a standard chemotherapy regimen, the patient suffered two hematologic relapses and died 34 months after diagnosis. The authors discuss the possibility that complete p16(INK4A) gene inactivation may adversely modify the prognostic significance of TEL/AML1 fusion in childhood acute lymphoblastic leukemia, and present evidence from clinical and in vitro observations in favor of this assumption.

What's in a name? Evidence that Papanicolaou, not Babes, deserves credit for the Pap test

The purpose of our study is to elaborate on the ongoing controversy regarding the origination of the Pap test between the supporters of George Papanicolaou and Aurel Babes. We studied the original articles published by Aurel Babes and George Papanicolaou and conducted a comparative evaluation of both methods. Babes' method is radically different from Papanicolaou's method. Differences included the sampling method, the fixation and staining technique, and the interpretation of the results regarding cases of cervical cancer. We conclude that the establishment of the technique in clinical practice and the idea of its application as preventive control of cervical cancer belong solely to George Papanicolaou.

Travelling through Time with Aspirin, a Healing Companion

Four thousand years ago the willow tree was known for its palliative effects. Ancient Greeks used the extract from the cortex and leaves to treat pain, fever, calluses and to enhance semen quality. Bayer Company and Felix Hoffmann claimed discovery of aspirin, and chemists all over Europe dealt with the synthesis of the drug. During 1988 the use of Aspirin was extended from an analgesic, antipyretic to a life-saving drug as it was suggested that it reduced the danger of cardiovascular accidents. Aspirin is still a drug that can offer much to medicine.

Anton van Leeuwenhoek (1632-1723): father of micromorphology and discoverer of spermatozoa

The Dutch merchant and naturalist Anton van Leeuwenhoek is considered to be the father of optic microscopy and the precursor of bacteriology. Among others, he discovered and studied the spermatozoon.

Drugs for mental illnesses in ancient greek medicine

Drugs with psychedelic, hypnotic, narcotic, analgesic, suppressive, euphoric and stimulating effects were used in various ways during the ancient times. We can classify drug use in ancient times into two main categories. On the one hand, ancient physicians prescribed drugs based on their pharmaceutical-therapeutic actions. On the other hand, people not pertaining to medicine and not relating to its accurate implementation often abused drugs to achieve an euphoric state of mind, either for personal gratification or as an indispensable element of religion and mythology. Ancient Greek medical literature contains ample prescriptions and recipes indicating that plants were the essential components of drugs. Pedanius Dioscorides dedicated his lifetime's work to the synthesis of ancient drugs. One can find a plethora of information concerning the production methods and the plants used in drugs for the treatment of psychiatric diseases. These were herbs like black and white hellebore, mandrake, hyoscyamus (henbane), Papaver somniferum (also known as opium poppy), Strychnos, Frankincense-tree and dorycnium. The preparation of narcotics included the addition of other elements, mainly wine, to the opus of plants or to their extracts. Drugs were produced via methods of dehumidification/desiccation, grinding, squeezing or boiling of the plants' roots with a formation of a juice, oil or mush extract. In addition, drugs could also be inhaled if burnt. Many physicians of antiquity, such as Hippocrates, Galen, Ctesias and Aretaeus of Cappadocia, all refer to many of these aforementioned drugs analyzing the different symptoms which they could address, and the risks accompanying their use. Physicians of antiquity used drugs for the treatment of somatic, as well as psychiatric disorders. Most of these drugs affected the central nervous system. Taking advantage of their analgesic properties, physicians used them for the management of severe and chronic painful conditions. The hypnotic effects of some drugs were desirable in order to be used as anesthetics for surgical operations and cauterization. Drug use was also established in the initial treatment of epilepsy and seizures, regardless of their cause. Public rituals and mythology were the two main contexts in which drug use flourished, outside the realms of medicine. The psychotropic and especially the hallucinatory effects of drugs caused the person under their influence to lose control, rendering him incapable of governing his actions and thoughts. These consciousness-altering medications were frequently the central focus of mythology. In this case, one would dictate and give orders to another person, which under any other circumstances would not be carried out. This led to the formation of the concept of the magic potion. Theophrastus frequently referred to magic potions.

Lasthénie de Ferjol syndrome: a rare disease with fascinating history

In our paper, we present the fascinating story of Lasthénie de Ferjol syndrome. A rare self-induced iron deficiency anaemia caused by surreptitious blood-letting. The French haematologist Jean Bernard first described the syndrome and named it after the heroine of Barbey d' Aurevilly's novel The Story without a Name. This factitious anaemia presents a great challenge for physicians even today, both in diagnosis and in therapy.

Dreams in ancient Greek Medicine

Dreams preoccupied the Greek and Roman world in antiquity, therefore they had a prominent role in social, philosophical, religious, historical and political life of those times. They were considered as omens and prophetic signs of future events in private and public life, and that was particularly accentuated when elements of actions which took place in the plot of dreams were associated directly or indirectly with real events. This is why it was important to use them in divination, and helped the growth of superstition and folklore believes. Medicine as a science and an anthropocentric art, could not ignore the importance of dreams, having in mind their popularity in antiquity. In ancient Greek medicine dreams can be divided into two basic categories. In the first one -which is related to religious medicine-dreams experienced by religionists are classified, when resorted to great religious sanctuaries such as those of Asclepius (Asclepieia) and Amphiaraos (Amfiaraeia). These dreams were the essential element for healing in this form of religious medicine, because after pilgrims underwent purifications they went to sleep in a special dwelling of the sanctuaries called "enkoimeterion" (Greek: the place to sleep) so that the healing god would come to their dreams either to cure them or to suggest treatment. In ancient Greek literature there are many reports of these experiences, but if there may be phenomena of self-suggestion, or they could be characterized as propaganda messages from the priesthood of each sanctuary for advertising purposes. The other category concerns the references about dreams found in ancient Greek medical literature, where one can find the attempts of ancient Greek physicians to interpret these dreams in a rational way as sings either of a corporal disease or of psychological distress. This second category will be the object of our study. Despite the different ways followed by each ancient Greek physician in order to explain dreams, their common intention was to give a rational answer for the creation and content of dreams setting aside any supernatural beliefs. In addition they tried to explain in a scientific way the correlation that could have emerged between the story that took place in dreams and the events that happened in everyday life. Nevertheless, ancient Greek physicians focused especially on nightmares, which were associated with physical problems. For those physicians these nightmares included information about the corporal disease of the patient, which had a reflection in the dream, and they could help them to diagnose the problem in order to restore balance of the body.

The medical-religious practice of votive offerings and the representation of a unique pathognomonic one inside the asclepieion of corinth

Votive offerings to the healing gods were a common religious custom for the ill believers to achieve the expected cure. The dedication of votive offerings began in Prehistoric Crete and continued during the Classical Period, mainly connected with the god Asclepius. Most offerings presented healthy members, while in some rare cases a disease had been displayed. A unique votive offering, found in the Asclepieion of Corinth, presented an anomaly, bringing to light the religious beliefs of the era. The custom of votive offerings was absorbed by the Orthodox Christians and still remains a common practice.

Penis carcinoma : The point of view of Alexis Boyer (1757-1833), eminent surgeon and anatomist

Alexis Boyer, professor of clinical surgery at "La Charité", first surgeon of Napoleon 1st, baron of the empire, left a considerable number of written works covering the whole of external pathology. A large portion of his work deals with cancerous diseases. By studying the chapter of penis carcinoma one can appreciate the astonishing depth of Boyer's knowledge on this matter, a knowledge which constitutes the seed of oncology.

Simon-Emmanuel Duplay’s (1836–1924) essay on cancer contagion

Simon-Emmanuel Duplay was a distinguished example of the French clinicopathological school and his researches on cancer inaugurated the modern period in oncology. In his book entitled Les tumeurs, he presents and analyses his research and those of his contemporaries on cancer contagion.

Baron Dominique-Jean Larrey (1766-1842): founder of military surgery and trauma care

Dominique-Jean Larrey was a distinguished surgeon in chief of Napoleon's army and a faithful servant of the Empire. His surgical skills and inventions, his absolute attachment and devotion to his profession, his humanitarian spirit and courage entitled him as one of history's greatest military surgeons.

Clovis Vincent (1879-1947): founder of French neurosurgery and promoter of oncologic neurosurgery

The eminent neurologist Clovis Vincent decided to become neurosurgeon at an advanced age. His is considered the founder of French neurosurgery and the Europe's first neurosurgeon. He was mainly interested in pituitary tumors and his work on oncologic neurosurgery remains valuable.

Suicide in ancient Greece

The theme of suicide appears several times in ancient Greek literature. However, each such reference acquires special significance depending on the field from which it originates. Most of the information found in mythology, but the suicide in a mythological tale, although in terms of motivation and mental situation of heroes may be in imitation of similar incidents of real life, in fact is linked with the principles of the ancient Greek religion. In ancient drama and mainly in tragedies suicide conduces to the tragic hypostasis of the heroes and to the evolution of the plot and also is a tool in order to be presented the ideas of poets for the relations of the gods, the relation among gods and men and the relation among the men. In ancient Greek philosophy there were the deniers of suicide, who were more concerned about the impact of suicide on society and also these who accepted it, recognizing the right of the individual to put an end to his life, in order to avoid personal misfortunes. Real suicides will be found mostly from historical sources, but most of them concern leading figures of the ancient world. Closer to the problem of suicide in the everyday life of antiquity are ancient Greek medicines, who studied the phenomenon more general without references to specific incidents. Doctors did not approve in principal the suicide and dealt with it as insane behavior in the development of the mental diseases, of melancholia and mania. They considered that the discrepancy of humors in the organ of logic in the human body will cause malfunction, which will lead to the absurdity and consequently to suicide, either due to excessive concentration of black bile in melancholia or due to yellow bile in mania. They believed that greater risk to commit suicide had women, young people and the elderly. As therapy they used the drugs of their time with the intention to induce calm and repression in the ill person, therefore they mainly used mandragora. In general, we would say that there were many reasons to suicide someone in antiquity. Very important factor was to avoid captivity and the consequent overcrowding of indignity, especially for politicians and military leaders. Also intention in these circumstances was to avoid torture and the disgrace of rape. Strong grief is another reason, as in case of death of family members. The erotic disappointment had place in ancient suicides, which concerned both men and women, while there were also suicide for financial reasons. Especially for the elderly, the despair of the anility in conjunction with physical illness and cachexia, were important factors for these people to decide thee suicidal. Finally, the methods of suicide fitted their epoch, but bear resemblance to those of the modern time. Poisoning was very common to both men and women but equally popular in both sexes was also the hanging. It was not unusual to fall from a high in order to reach the death, while stabbing a sword in the body for self killing was widespread in men and soldiers.

La contribution de l’Encyclopédie à la vulgarisation des notions en anatomie andrologique au siècle des Lumières

Au siècle des Lumières, les notions en anatomie andrologique des grands anatomistes, tels que De Graaf, Morgagni, Duverney, Heister, Ruysch, grâce à l’Encyclopédie, connurent une grande promulgation et purent être vulgarisées aussi bien dans le monde scientifique qu’auprès du grand public.

A neurologist in the origin of European and International neurosurgery: Clovis-Julien-Désiré Vincent (1879-1947)

Vincent Clovis began his carrier as a neurologist and finally became neurosurgeon at an advanced age. He is considered the founder of French neurosurgery, and after Harvey Williams Cushing, Europe's first neurosurgeon. He was mainly interested in pituitary tumors, in cerebral abscesses and in cerebral oedema.

Julius Wagner-Jauregg (1857-1940): Introducing fever therapy in the treatment of neurosyphilis

For centuries, heat has been used in various ways for the cure of mental diseases. Hippocrates noted that malarial fever could have a calming effect in epileptics. Centuries later, Galen described a case of melancholy cured as a result of an attack of quartan fever. In 19th century, the eminent French psychiatrist Philippe Pinel, in his treatise on insanity referred to the beneficial effect of fever. An opinion expressed few years later by his pupil Jean-Étienne Dominique Esquirol in his treatise entitled Des maladies mentales considérées sous les rapports médical, hygiénique et médico-légal. However, in 1917, the Austrian neuro-psychiatrist Julius Wagner Jauregg pointed out the therapeutic value of malaria inoculation in the treatment of dementia paralytica. In 1927, Wagner Jauregg received for this work the Nobel Prize in Medicine, being actually the first psychiatrist to win the Nobel Prize. He studied medicine at the University of Vienna and received his doctorate in 1880. In 1889, he was appointed Professor of Psychiatry and Director of the Graz's Psychiatric Clinic, a position that he held until 1928. Working in the asylum, Wagner Jauregg noted that insane patients with general paralysis occasionally became sane after some febrile episode. After experimenting with several artificial methods (streptococci, tuberculin) to induce fever, he concluded that malaria was the most satisfactory. Actually, malaria infection was an acceptable risk for the patients, as quinine would be administered as soon as syphilis was cured. In 1917, he reported the first favorable results of his study. Patients were inoculated via intravenous injections with malaria. Some physicians were starting the administration of anti-syphilitic treatment (bismuth, salvarsan and later penicillin) after 10-12 febrile paroxysms, while others initiated the regimen the first febrile-free day after 8 malarial paroxysms. The therapeutic regimen was completed with the administration of quinine sulfate to terminate the malaria infection. It is worth mentioning that the above treatment was followed in hospital under strict monitoring of patients' vital signs and regular laboratory tests. In the following years of his discovery, artificial fever was induced by any one of the following methods: the introduction into the patient of a parasitic disease; the injection of a foreign protein; injections of chemical substances such as sulphur; electrical means such as the administration of diathermy or radiotherapy, or placing the patient in an electromagnetic field; and simple immersion of the individual in a hot bath, or placing him in a heat cabinet. Wagner Jauregg's therapy was highly admired and was used on neurosyphilis cases well onto the 1950's. However, with the introduction of penicillin in syphilis' treatment, fever therapy effectively ended. Wagner Jauregg's study led to all the methods of stress therapy used in psychiatry, as electric shock, and insulin.

Professor Miltiades Papamiltiades (1907-1987): 20 years since the death of an eminent Greek anatomopathologist and cytologist

Professor Miltiades Papamiltiades was an outstanding Greek anatomopathologist and cytologist. By his researches on lymphatic vessels and the invention of new staining techniques in exfoliative cytology, continued the work of his predecessor George Papanicolaou against the cancer.