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Koehler U, Hildebrandt O, Conradt R, Koehler J, Hildebrandt W. [The Road to Discovery of the Pulmonary Gas Exchange - From the "Phlogiston-" to the "Oxygen Theory"]. Pneumologie 2021; 76:275-280. [PMID: 34710936 DOI: 10.1055/a-1579-8387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The discovery of oxygen and pulmonary gas exchange was a major advancement in our understanding of breathing. For centuries it was believed that the lungs were primarily necessary to cool the heart or to "refine" the blood. Richard Lower (1631-1691) observed that the blood had a different colour before and after passage through the lung. His assumption was that breathing must have been added a special substance to the blood. Georg Ernst Stahl (1660-1734) formulated a fire substance "phlogiston" (phlox = flame) with his phlogiston theory. He postulated that phlogiston is contained in all combustible substances and escapes when burned. John Mayow (1641-1679) recognised that about one fifth of the breathing gas is important for the breathing process. He called the gas "spiritus nitro aerius". Oxygen was first discovered in the early 1770 s by the Swedish-German pharmacist Carl Wilhelm Scheele (1742-1786) and the English chemist Joseph Priestley (1733-1804) - independently of each other. Antoine-Laurent Lavoisier (1743-1794) recognised oxygen as element and for the first time described the oxidation process accurately.
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Affiliation(s)
- Ulrich Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg, Marburg
| | - Olaf Hildebrandt
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg, Marburg
| | - Regina Conradt
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Philipps-Universität Marburg, Marburg
| | - Julian Koehler
- Klinik für Innere Medizin, SP Gastroenterologie, Endokrinologie und klinische Infektiologie, Philipps-Universität, Marburg
| | - Wulf Hildebrandt
- Medizinische Zellbiologie, Institut für Anatomie und Zellbiologie, Philipps-Universität Marburg, Marburg
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Buitrago-Ricaurte N, Cintra F, Silva GS. Heart rate variability as an autonomic biomarker in ischemic stroke. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 78:724-732. [PMID: 33331466 DOI: 10.1590/0004-282x20200087] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/18/2020] [Indexed: 01/01/2023]
Abstract
Stroke is one of the leading causes of mortality and disability worldwide. Autonomic dysfunction after ischemic stroke is frequently associated with cardiac complications and high mortality. The brain-heart axis is a good model for understanding autonomic interaction between the autonomic central network and the cardiovascular system. Heart rate variability (HRV) analysis is a non-invasive approach for understanding cardiac autonomic regulation. In stroke patients, HRV parameters are altered in the acute and chronic stages of the disease, having a prognostic value. In this literature review we summarize the main concepts about the autonomic nervous system and HRV as autonomic biomarkers in ischemic stroke.
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Affiliation(s)
| | - Fátima Cintra
- Universidade Federal de São Paulo, Department of Cardiology, São Paulo SP, Brazil
| | - Gisele Sampaio Silva
- Universidade Federal de São Paulo, Department of Neurology, São Paulo SP, Brazil
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Neder JA. Cardiovascular and pulmonary interactions: why Galen's misconceptions proved clinically useful for 1,300 years. ADVANCES IN PHYSIOLOGY EDUCATION 2020; 44:225-231. [PMID: 32412380 DOI: 10.1152/advan.00058.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The new generations of physicians are, to a large extent, unaware of the complex philosophical and biological concepts that created the bases of modern medicine. Building on the Hellenistic tradition of the four humors and their qualities, Galen (AD 129 to c. 216) provided a persuasive scheme of the structure and function of the cardiorespiratory system, which lasted, without serious contest, for 1,300 yr. Galen combined teleological concepts with careful clinical observation to defend a coherent and integrated system in which the fire-heart-flaming at the center of the body-interacts with lungs' air-pneuma to create life. Remarkably, however, he achieved these goals, despite failing to grasp the concept of systemic and pulmonary blood circulations, understand the source and destiny of venous and arterial blood, recognize the lung as the organ responsible for gas exchange, comprehend the actual events taking place in the left ventricle, and identify the source of internal heat. In this article, we outline the alternative theories Galen put forward to explain these complex phenomena. We then discuss how the final consequences of Galen's flawed anatomical and physiological conceptions do not differ substantially from those obtained if one applies modern concepts. Recognition of this state of affairs may explain why the ancient practitioner could achieve relative success, without harming the patient, to understand and treat a multitude of symptoms and illnesses.
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Affiliation(s)
- J Alberto Neder
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Kingston Health Science Center & Queen's University, Kingston, Ontario, Canada
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Koehler U, Hildebrandt O, Hildebrandt W, Aumüller G. [Historical (cultural) view of the heart and cardiovascular system]. Herz 2020; 46:33-40. [PMID: 32291485 PMCID: PMC8043882 DOI: 10.1007/s00059-020-04914-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 07/04/2019] [Accepted: 03/19/2020] [Indexed: 11/30/2022]
Abstract
Who discovered the cardiovascular and capillary systems? When students in advanced semesters are asked about historical matters that have decisively influenced the path to present day medicine, as a rule no answer or a false answer is forthcoming. Whoever wants to understand scientific thinking and action, cannot do better than to grapple with the historical and cultural developments in medicine; however, more than any other science the natural sciences and medicine provide evidence that new ways and knowledge must be consistently sought for the benefit of patients. The aim of this article is to make a contribution to remembering how the cardiovascular system was discovered and the cultural and historical importance of the heart. Last but not least, however, the article aims to convey the impression of the huge personal sacrifice, including one's own life, and the stony path which led to the acquisition of this knowledge.
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Affiliation(s)
- Ulrich Koehler
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Universitätsklinikum Giessen und Marburg GmbH, Philipps-Universität Marburg, Baldingerstraße 1, 35033, Marburg, Deutschland.
| | - Olaf Hildebrandt
- Klinik für Innere Medizin, SP Pneumologie, Intensiv- und Schlafmedizin, Universitätsklinikum Giessen und Marburg GmbH, Philipps-Universität Marburg, Baldingerstraße 1, 35033, Marburg, Deutschland
| | - Wulf Hildebrandt
- Medizinische Zellbiologie, Institut für Anatomie und Zellbiologie, Philipps-Universität Marburg, Marburg, Deutschland
| | - Gerhard Aumüller
- Emil-von-Behring-Bibliothek, Arbeitsstelle für Geschichte der Medizin, Philipps-Universität Marburg, Marburg, Deutschland
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Ratzan RM. "Tactile": A Commentary. J Emerg Med 2018; 55:442-444. [PMID: 30037515 DOI: 10.1016/j.jemermed.2018.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 06/06/2018] [Indexed: 06/08/2023]
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Khodadoust K, Ardalan M, Ghabili K, Golzari SE, Eknoyan G. Discourse on pulse in medieval Persia—the Hidayat of Al-Akhawayni (?–983AD). Int J Cardiol 2013; 166:289-93. [DOI: 10.1016/j.ijcard.2012.04.043] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Accepted: 04/09/2012] [Indexed: 10/28/2022]
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Abstract
Heart rate variability (HRV), the beat-to-beat variation in either heart rate or the duration of the R-R interval - the heart period, has become a popular clinical and investigational tool. The temporal fluctuations in heart rate exhibit a marked synchrony with respiration (increasing during inspiration and decreasing during expiration - the so called respiratory sinus arrhythmia, RSA) and are widely believed to reflect changes in cardiac autonomic regulation. Although the exact contributions of the parasympathetic and the sympathetic divisions of the autonomic nervous system to this variability are controversial and remain the subject of active investigation and debate, a number of time and frequency domain techniques have been developed to provide insight into cardiac autonomic regulation in both health and disease. It is the purpose of this essay to provide an historical overview of the evolution in the concept of HRV. Briefly, pulse rate was first measured by ancient Greek physicians and scientists. However, it was not until the invention of the "Physician's Pulse Watch" (a watch with a second hand that could be stopped) in 1707 that changes in pulse rate could be accurately assessed. The Rev. Stephen Hales (1733) was the first to note that pulse varied with respiration and in 1847 Carl Ludwig was the first to record RSA. With the measurement of the ECG (1895) and advent of digital signal processing techniques in the 1960s, investigation of HRV and its relationship to health and disease has exploded. This essay will conclude with a brief description of time domain, frequency domain, and non-linear dynamic analysis techniques (and their limitations) that are commonly used to measure HRV.
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Affiliation(s)
- George E. Billman
- Department of Physiology and Cell Biology, The Ohio State UniversityColumbus, OH, USA
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Ghasemzadeh N, Zafari AM. A brief journey into the history of the arterial pulse. Cardiol Res Pract 2011; 2011:164832. [PMID: 21811677 PMCID: PMC3147130 DOI: 10.4061/2011/164832] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Revised: 04/26/2011] [Accepted: 05/20/2011] [Indexed: 11/20/2022] Open
Abstract
Objective. This paper illustrates the evolution of our knowledge of the arterial pulse from ancient times to the present. Several techniques for arterial pulse evaluation throughout history are discussed. Methods. Using databases including Worldcat, Pubmed, and Emory University Libraries' Catalogue, the significance of the arterial pulse is discussed in three historical eras of medicine: ancient, medieval, and modern. Summary. Techniques used over time to analyze arterial pulse and its characteristics have advanced from simple evaluation by touch to complex methodologies such as ultrasonography and plethysmography. Today's understanding of the various characteristics of the arterial pulse relies on our ancestors' observations and experiments. The pursuit of science continues to lead to major advancements in our knowledge of the arterial pulse and its application in diagnosis of atherosclerotic disease.
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Affiliation(s)
- Nima Ghasemzadeh
- Atlanta Veterans Affairs Medical Center, Decatur, GA 30033-4004, USA
- Division of Cardiology, Emory University School of Medicine, 1639 Pierce Drive, 322 WMB, Atlanta, GA 30322, USA
| | - A. Maziar Zafari
- Atlanta Veterans Affairs Medical Center, Decatur, GA 30033-4004, USA
- Division of Cardiology, Emory University School of Medicine, 1639 Pierce Drive, 322 WMB, Atlanta, GA 30322, USA
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Alexandrian medicine. EGYPTIAN LIVER JOURNAL 2011. [DOI: 10.1097/elx.0000397038.50327.ee] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Liddelow SA. Fluids and barriers of the CNS: a historical viewpoint. Fluids Barriers CNS 2011; 8:2. [PMID: 21349150 PMCID: PMC3039834 DOI: 10.1186/2045-8118-8-2] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Accepted: 01/18/2011] [Indexed: 02/03/2023] Open
Abstract
Tracing the exact origins of modern science can be a difficult but rewarding pursuit. It is possible for the astute reader to follow the background of any subject through the many important surviving texts from the classical and ancient world. While empirical investigations have been described by many since the time of Aristotle and scientific methods have been employed since the Middle Ages, the beginnings of modern science are generally accepted to have originated during the 'scientific revolution' of the 16th and 17th centuries in Europe. The scientific method is so fundamental to modern science that some philosophers consider earlier investigations as 'pre-science'. Notwithstanding this, the insight that can be gained from the study of the beginnings of a subject can prove important in the understanding of work more recently completed. As this journal undergoes an expansion in focus and nomenclature from cerebrospinal fluid (CSF) into all barriers of the central nervous system (CNS), this review traces the history of both the blood-CSF and blood-brain barriers from as early as it was possible to find references, to the time when modern concepts were established at the beginning of the 20th century.
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Abstract
Heart rate variability (HRV), the beat-to-beat variation in either heart rate or the duration of the R-R interval - the heart period, has become a popular clinical and investigational tool. The temporal fluctuations in heart rate exhibit a marked synchrony with respiration (increasing during inspiration and decreasing during expiration - the so called respiratory sinus arrhythmia, RSA) and are widely believed to reflect changes in cardiac autonomic regulation. Although the exact contributions of the parasympathetic and the sympathetic divisions of the autonomic nervous system to this variability are controversial and remain the subject of active investigation and debate, a number of time and frequency domain techniques have been developed to provide insight into cardiac autonomic regulation in both health and disease. It is the purpose of this essay to provide an historical overview of the evolution in the concept of HRV. Briefly, pulse rate was first measured by ancient Greek physicians and scientists. However, it was not until the invention of the "Physician's Pulse Watch" (a watch with a second hand that could be stopped) in 1707 that changes in pulse rate could be accurately assessed. The Rev. Stephen Hales (1733) was the first to note that pulse varied with respiration and in 1847 Carl Ludwig was the first to record RSA. With the measurement of the ECG (1895) and advent of digital signal processing techniques in the 1960s, investigation of HRV and its relationship to health and disease has exploded. This essay will conclude with a brief description of time domain, frequency domain, and non-linear dynamic analysis techniques (and their limitations) that are commonly used to measure HRV.
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Affiliation(s)
- George E Billman
- Department of Physiology and Cell Biology, The Ohio State University Columbus, OH, USA
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