News #14 | May, 2010
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100 Years of Medicine: a Historical Perspective [1910-2010] Part II

Manuel Valente Alves
Director of the FMUL Museum of Medicine

Surgery and Transplants 

In 1947 João Cid dos Santos invented the surgical technique of endarterectomy when unblocking, for the first time in the world, an occluded femoral artery, a technique which is still used today. 

Figure 1Figure 2

In 1967 the first successful heart transplant was carried out by the South African heart surgeon Christiaan Barnard. 

In the same year Jean Baptiste Dausset, a French doctor, and his collaborators discovered a solution for the rejection of organ and tissue transplants after in 1958 having demonstrated that determined actions observed in blood transfusions of the same blood Landsteiner group were due to the leucocytes in the population and not the red globules. Dausset’s team investigated the antigenic types of the leucocytes in the population and concluded that they were part of a system that controls the rejection of transplants. George Snell, who was carrying out similar research in the USA, proposed the name “human-lymphocyte-antigen” (HLA) for this system, a part of a greater complex of histocompatibility (MHC). In 1967, in collaboration with Felix Rapapport, Dausset came to the conclusion that transplants between members of the same family with identical HLA had greater probabilities of success than when the antigenic types were different. Dausset was also the first scientist to associate HLA with illnesses, which led other researchers to explore this possibility, proving the association of the antigenic pattern of the lymphocytes with the greatest risk of acquiring determined illnesses such as rheumatoid arthritis, anti-immune illnesses and diabetes. Jean Baptiste Dausset, Baruj Benacerraf and George Snell jointly received the Nobel Prize in 1980. 

In 1987 the French surgeon Philipe Mouret began “minimal Access surgery, laparoscopy or minimally invasive surgery”, the first video-laparoscopic cholecystectomy, in which the spleen was removed from the abdominal cavity through tiny divergent incisions in the abdomen.
From 1850 to 1950 surgery lived its “golden century” due to the appearing of anaesthesia, asepsis and antisepsis in the XIX century and antibiotics in the XX century.

From the second half of the XX century on there was also enormous progress in organ transplants, in oncology, in trauma, in the treatment of social diseases (like obesity and aging diseases) and in other pathologies, due to the rigour of the technological and therapeutic supports.

New Illnesses and Epidemics 

In 1951, the Portuguese doctor Corino de Andrade (1906-2005) discovered Familial Amyloidotic Polyneuropathy or Corino de Andrade’s Disease, commonly known in Portugal as “Feet Disease”.
At the end of the nineteen seventies and beginning of the eighties illnesses will appear associated to hitherto unknown micro-organisms – Legionnella Pneumophila (“Legionnaire’s Disease”), the African haemorrhaging illnesses (Ebola, Lassa Fever) and, above all, HIV. Acquired Immuno-Deficiency Syndrome (AIDS) was identified for the first time in 1981. The first test for HIV was approved in 1985. Over the following years drugs began to be researched not only to fight the virus, but also to prevent the infections that result from the harming of the immune system by HIV. According to the 2006 Report on the global AIDS epidemic by the UNAIDS [United Nations Programme on AIDS], “in only 25 years HIV has gone from some ‘hot spots’ spread over the globe to virtually each and every country in the world, infecting 65 million people and killing 25 millions.”

New Image technology

Em 1933,Ernst Ruska, a German physicist, invented the electronic microscope. 

Figure 3

In 1945, Rosalyn Yalow, a US scientist, and Salomon Berson a US doctor, began a broad Project for studying the use of radioisotopes in medicine. Yalow created an extremely sensitive method, which she called radioisotope tracing (RIA), later replaced by the immuno-enzymatic (ELISA), based on the same principles. Rosalyn Yalow received the Nobel Prize for this invention in 1977. 

In 1946, the physicists Felix Bloch, from Switzerland, and Edward Mills Purcell, from the USA, discover nuclear magnetic resonance, one of the most powerful spectroscopic techniques ever invented. For decades magnetic resonance was used mainly for studying chemical structures. Visualising the body through MR images was carried out for the first time in the nineteen seventies by Peter Mansfield, a British physicist, and Paul Lauterbur, both awarded the Nobel Prize for Physiology and Medicine in 2003. 

In 1957 the fiber optic endoscope is created. The idea for its construction was due to Basil Hirschowitz, a South African doctor who, when on a training period in Ann Arbor, in the USA, joined up with the physicist Larrey Curtiss, with whom he worked from 1954 to 1957 on its construction. 

Computerised tomography was conceived in 1967 by Godfrey Newbold Hounsfield, a British electrotechnical engineer. Allan McLeod Cormack, a South African biologist, working separately (he did not even know of Hounsfield’s existence), invented a similar process, for which reason the Nobel Prize was awarded to both, in 1979. 

In 1981, the Swiss and German physicists Gerd Binnig and Heinrich Rohrer, invent the scanning tunnel microscope (STM), which allows visualisation of individual atoms. In 1986 they received the Nobel Prize, along with Ernst Ruska, the inventor of the electronic microscope.

The Pill, the Test-Tube Baby and Dolly the Sheep 

In 1960, Enovid-10, the first combined oral contraceptive pill is launched in the USA, having been invented by Gregory Goodwin Pincus, a biologist and researcher, and John Rock, a gynaecologist, both from the USA. The first commercialised pill in Portugal appeared in 1962.
On the 25th of July 1978 Louise Brown was born in Bristol, England, the first “test-tube baby” in the world, and the result of artificial insemination or in vitro fertilization, assisted by Robert Edward and Patrick Steptoe, of the Bourn Hall Clinic in Cambridge. 

Dolly the sheep, the first mammal in the world to be successfully cloned from an adult cell, was born in 1997. She lived for six years. The credits for this experiment are attributed to Ian Wilmut and Keith Campbell, both English embryologists and researchers from the Roslin Institute in Scotland. 

Cybernetics and the Internet 

In 1936, Alan Turing, an English mathematician, published the article “On computable numbers, with an application to the Entscheidungsproblem”, presented four years earlier at the London Mathematical Society, in which he describes a very simple abstract machine that would be capable of automatically performing a calculation as long as its configuration were defined by an instructions chart – “Turing’s machine” which prefigures the logical structure of modern digital computers. Turing worked not only on the development of the first electronic computers, but also on the genesis of the theories of artificial intelligence and on the application of mathematics to biological forms.

In 1946, John von Neuman, Norbert Wiener, Warren McCulloch and other scientists get together in a hotel in New York City convinced that the mind operates like a machine and that it is possible, using physics, to integrate the meaning of nature. The code name used to designate this movement was “cybernetics”. 

In 1989, the English scientist Tim Berners-Lee, a researcher at the Conseil Européen pour la Recherche Nucléaire (CERN) [European Nuclear Research Centre] in Switzerland, definitively changes the face of the Internet, creating the World Wide Web, a system of artificial intelligence that linked systems of scientific and academic research from several different universities. In 1991, Berners-Lee published a new project for the World Wide Web, two years after starting to create the HTML, the HTTP and the first web pages at the CERN, in Switzerland. The CERN had no idea of the proportions that the World Wide Web would take on. In 1993 the NCSA (National Center for Supercomputing Applications) launches the first web browser, the navigator X Windows Mosaic 1.0. The launching of this browser was responsible for the popularising of the Internet, which was thus set free from the academic field. In 1996 the word Internet was in common use, principally in the developed countries. Its reference is the initials www. This confusion between the nomenclature Internet and Web is still common today, but it is important to stress that the Web is only a part of the Internet. Until Berners-Lee’s discovery the Internet was a closed network with an interface that is very different to what we know today. Indeed, the worldwide computer network appears in the sixties, at the height of the Cold War, with the ARPANET, created by the ARPA [Advanced Research Projects Agency] at the United States Defense Department, a system intended for exchanging and sharing information in a non-centralised manner in order to avoid its disappearance in the case of an attack on a documentation centre. The prototype for Arpanet was created in 1969, and its first public demonstration took place in 1972.


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