Orvostorteneti kozlemenyek最新文献

Trephination of the cranial vault is the oldest known surgical procedure and has often been reported in literature. Residuals of ancient trephinations have been found all over Europe. In present study both the recorded and unpublished trephined cases found in Hungary are reviewed. Four Neolithic, two Copper Age, eight Bronze Age, seven Covering Age (4th-6th century AD), twelve Awar Age (7th-9th century AD) seventy one Conquest Age (10th century AD) and eleven Arpadian Age (11th-13th century) cases are found. On the base of archeological, historical and paleopathologic aspects trephination is mainly (67%) connected with the Hungarians of the 10th century. The finds in our study are from whole territories of country (North-East Hungary, the zone of Great Plain, Northern Highlands, Danube-Tisza Mid-Region, the broader geographical vicinity of Budapest, Transdanubia and Transylvania). The surgical trepanation was practiced on both males (75.6%), females (15.7%), from the second period of infancy (2.6%) until the beginning senility, and persons. with undetermined age and gender. Considering the presumed time of the trephination and the time of death, trephinations were employed for every age, while the majority of investigations were performed on persons between 21 and 50 years of age. The majority of trephinations (84.4%) were performed in the parietal and/or frontoparietal regions. The long time surviving rate is 63% among the pre-Hungarians, while 84% among the 10th century Hungarian cases. The records of trephined cases excavated in Hungary are published in Hungarian, mostly in the annals of museums, but no cases were published in international periodicals. Consequently, the giant great trephined material (115 cases) of Hungary is unknown in the international scientific literature, although, in their detailed study Piek et al. (1999) counted altogether 450 trephined skulls found in Europe.

The author reviews the history of atrial fibrillation, the most common sustained cardiac arrhythmia. The chaotic irregularity of arterial pulse was clearly acknowledged by most of physicians of the ancient China, Egypt and Greece. William Harvey (1578-1657), who first described the circulatory system appropriately, was probably the first to describe fibrillation of the auricles in animals in 1628. The French "clinical pathologist", Jean Baptist de Sénac (1693-1770) was the first who assumed a correlation between "rebellious palpitation" and stenosis of the mitral valve. Robert Adams (1791-1875) also reported in 1827 the association of irregular pulses and mitral stenosis. The discovery of digitalis leaf in 1785 by William Withering (1741-1799) brought relief to patients with atrial fibrillation and congestive heart failure by reducing the ventricular rate. From an analysis of simultaneously recorded arterial and venous pressure curves, the Scottish Sir James Mackenzie (1853-11925) demonstrated that a presystolic wave cannot be seen during "pulsus irregularis perpetuus", a term very first used by Heinrich Ewald Hering (1866-1948). Arthur Cushny (1866-1926) noted the similarity between pulse curves in clinical "delirium cordis" and those in dogs with atrial fibrillation. The first human ECG depicting atrial fibrillation was published by Willem Einthoven (1860-1927) in 1906. The proof of a direct connection between absolute arrhythmia and atrial fibrillation was established by two Viennese physicians, Carl Julius Rothberger and Heinrich Winterberg in 1909. Sir Thomas Lewis (1881-1945), the father of modem electrocardiography, studied electrophysiological characteristics of atrial fibrillation and has shown that its basic perpetuating mechanism is circus movement of electrical impulse (re-entry). After him, the major discoveries relating to the pathophysiology and clinical features of atrial fibrillation in the 20th century stemmed from Karel Frederick Wenckebach (1864-1940), Gordon Moe (1915-1989), Bernhard Lown (*1921) and Maurits Allessie. Over the past ten years, awareness has increased of transcatheter radiofrequency and cryoablation of non-valvular atrial fibrillation and the battle against formation of intraatrial thrombi for preventing cerebral thromboembolism.