Alfred Blalock. Surgeon,Educator, and Pioneer in Shock and Cardiac Research

Alfred Blalock (1899–1964) was a pioneer American surgeon who made significant advances in the knowledge and treatment of hemorrhagic and traumatic shock as well as in the palliative treatment of congenital heart disease, particularly tetralogy of Fallot. This historical note reviews highlights in the life and accomplishments of Alfred Blalock, noted academic surgeon and researcher.

Blalock originated from Culloden, Georgia and attended Georgia Military College, the University of Georgia, and Johns Hopkins Medical School. He finished his surgical training at Vanderbilt University where he remained ultimately as professor of surgery until 1941 when he became the Chairman and Professor of Surgery at Johns Hopkins Medical School. His research in shock saved many soldiers' lives in World War II. In 1944 he performed the first subclavian-pulmonary artery shunt for tetralogy of Fallot with the support of the superb pediatric cardiologist Helen Taussig and the great technical help of Viven Thomas. Hundreds of operations followed. He educated and trained an incredible cadre of cardiovascular surgeons. He passed away in Baltimore, Maryland, on September 15, 1964.     

The History of Surgery According to Owen Wangensteen

Owen Wangensteen (1898–1981), the great Minnesota surgical master, made a firm and intense dedication to the history of surgery from the early stages of his exemplary surgical career. While in Germany and Switzerland, he learned from distinguished European professors and clearly realized the importance of history on the understanding and appreciation of important surgical problems. In 1928, on returning to Minneapolis, he began his quest to introduce history into many of his clinical and research laboratory works. In 1930, he attained the surgery chairmanship at the University of Minnesota, and there he excelled until his retirement from surgical practice in 1967. Throughout his career and until he died in 1981, the history of surgery was his continuous and persistent companion. In fact, this discipline, the history of surgery, was indeed part of the family, since his wife Sally Davidson Wangensteen was a dedicated contributor to their common papers and the scholarly jewel of their work, the monumental treatise, The Rise of Surgery: From Empiric Craft to Scientific Discipline.     

Sir David Wilkie (1882-1938): surgeon, scientist and philanthropist

Until the start of the 20th century, appointment to a chair in surgery in Britain was usually awarded in recognition of an already successful career. Sir David Wilkie was among the first of the new breed of professors of surgery appointed at a relatively young age to develop surgical research and undergraduate teaching. At the University of Edinburgh, he established a surgical research laboratory from which was to emerge a cohort of young surgical researchers destined to become the largest dynasty of surgical professors yet seen in the British Isles. He is widely regarded as the father of British academic surgery. Born in the same Scottish village as the writer JM Barrie (1860-1937), like Barrie, Wilkie became a philanthropist. Both men were to achieve eminence in later life and when Barrie was appointed Chancellor of Edinburgh University, their friendship developed. Barrie's legacy to Great Ormond Street Children's Hospital was one of the greatest ever acts of medical philanthropy, and Wilkie too proved to be a generous benefactor of the disadvantaged.     

Alfred Blalock. Surgeon, educator, and pioneer in shock and cardiac research.

Alfred Blalock (1899-1964) was a pioneer American surgeon who made significant advances in the knowledge and treatment of hemorrhagic and traumatic shock as well as in the palliative treatment of congenital heart disease, particularly tetralogy of Fallot. This historical note reviews highlights in the life and accomplishments of Alfred Blalock, noted academic surgeon and researcher. Blalock originated from Culloden, Georgia and attended Georgia Military College, the University of Georgia, and Johns Hopkins Medical School. He finished his surgical training at Vanderbilt University where he remained ultimately as professor of surgery until 1941 when he became the Chairman and Professor of Surgery at Johns Hopkins Medical School. His research in shock saved many soldiers' lives in World War II. In 1944 he performed the first subclavian-pulmonary artery shunt for tetralogy of Fallot with the support of the superb pediatric cardiologist Helen Taussig and the great technical help of Viven Thomas. Hundreds of operations followed. He educated and trained an incredible cadre of cardiovascular surgeons. He passed away in Baltimore, Maryland, on September 15, 1964.     

Congenital heart disease: a surgical-historical perspective

Pediatric cardiac surgery began with Dr Gross's first successful ligation of a patent ductus arteriosus on August 8, 1938, at the Children's Hospital in Boston. The beginnings of open-heart surgery for repair of congenital malformations, aside from Gibbon's first successful closure in Philadelphia of an atrial septal defect using an artificial heart-lung machine, can be traced to members of the Department of Surgery at the University of Minnesota during the fifties and sixties of the 20th century. This story will be told, and other advances will be discussed, some of which also carry the imprint of the Minnesota surgical training program, with its heavy emphasis on research.     

The history of surgery according to Owen Wangensteen.

Owen Wangensteen (1898-1981), the great Minnesota surgical master, made a firm and intense dedication to the history of surgery from the early stages of his exemplary surgical career. While in Germany and Switzerland, he learned from distinguished European professors and clearly realized the importance of history on the understanding and appreciation of important surgical problems. In 1928, on returning to Minneapolis, he began his quest to introduce history into many of his clinical and research laboratory works. In 1930, he attained the surgery chairmanship at the University of Minnesota, and there he excelled until his retirement from surgical practice in 1967. Throughout his career and until he died in 1981, the history of surgery was his continuous and persistent companion. In fact, this discipline, the history of surgery, was indeed part of the family, since his wife Sally Davidson Wangensteen was a dedicated contributor to their common papers and the scholarly jewel of their work, the monumental treatise, The Rise of Surgery: From Empiric Craft to Scientific Discipline.     

Man is fashioned, not born: the contributions of George J. Heuer to surgical education

George Heuer undertook his medical education and residency training in surgery at Johns Hopkins. He then joined the surgical faculty under Halsted. He became Chair of Surgery at the University of Cincinnati in 1922, where he developed the second formal surgical training program modeled on Halsted's principles. Subsequently, he became Chair of Surgery at Cornell where he founded another surgical residency. His training programs stressed broad and thorough experience, and he championed increasing resident responsibility and independence. The demonstrated efficacy of his surgical residencies assisted greatly in the formation of subsequent resident training programs across this country.     

25th Annual Vascular Surgery Seminar and Meeting of the Society for Military Vascular Surgery.

The 25th Annual (Silver Anniversary) Vascular Surgery Seminar and Meeting of the Society for Military Vascular Surgery was held in the Jay P. Sanford Auditorium at the F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences (USUHS), 4-6 December 1997. This highly successful exchange included active duty military surgeons, military surgeons in the reserves, retired military officers continuing second careers in civilian vascular surgery, distinguished visiting professors from the United States and abroad, International Guest Scholars, USUHS Faculty as well as colleagues and friends. The emphasis continued to be directed to ensuring that military vascular surgery remains current, recognizing the rich heritage of contributions to vascular surgery in general that have come from surgeons serving on battlefields around the world, particularly in this 20th century.     

Francesco Durante: the history of intracranial meningiomas and beyond

FRANCESCO DURANTE FROM Letojanni, Sicily, was the first surgeon in the history of neurosurgery to successfully remove a cranial base meningioma. Durante was Chairman of Clinical Surgery at the Royal University of Rome (now University "La Sapienza") for 45 years, participating in the birth of the "Policlinic Umberto I," and was one of the most famous surgeons in the country. He was also a Master in general surgery, a Senator of the Kingdom of Italy, and a personal friend of the King of Italy and the Emperor of Austria-Hungary. His contributions are still applicable to medicine today, not only to the neurosurgical community, but also other surgical disciplines, because he developed innovative practices in the fields of oncology, general surgery, and orthopedics in addition to designing special surgical instruments. In commemoration of his legacy, the International Francesco Durante Award is bestowed upon world-renowned surgeons.     

William Arbuthnot Lane (1856-1943) and Kenelm Hutchinson Digby (1884-1954): a tale of two universities

Sir William Arbuthnot Lane was one of the most brilliant British technical surgeons during the first half of the 20th century. Although some of his ideas may be controversial, he made many original contributions and innovations in surgical techniques. His greatest contribution was the introduction of the 'no-touch technique' in the open reduction and plating of long bone fractures by Lane's steel plates and screws. One of his registrars, Kenelm Hutchinson Digby, came to the Far East in 1913 as one of the first professors in the newly founded University of Hong Kong. Digby brought his former mentor's ideas to Hong Kong and inaugurated the practice of modern surgery there.     

我国普通外科医师培养模式及教学面临的问题及对策

当前,我国普通外科要以国际标准完善住院医师和专科培训,涵盖医学教育连续统一体的3个阶段。外科基础课程和外科技能课程能有效地提升学生的基本手术技术和能达到全球医学教育最基本要求。医师工作时间的限制和病人安全意识的加强改变了住院医师教育和培训的模式。普通外科医师的专业化与当前的临床实践是重要问题。研究生的教育应与专科医师培训相结合。跨专业教育和学习服务是对未来医疗卫生教育的一种模式。基于虚拟技术的外科培训和模拟中心完全改变了教育的程序,特别是住院医师培训的腹腔镜和机器人外科课程。虚拟现实技术是近年出现的计算机辅助应用技术,在医学教育领域展显优势。电子学习系统将发挥重要作用。     

A profile of female academic surgeons: training, credentials, and academic success

The objective of this study was to determine the profile (credentials, training, and type of practice) of female academic general surgeons and factors that influenced their career choice. A survey was sent to female academic surgeons identified through general surgery residency programs and American medical schools. The women had to be Board eligible/certified by the American Board of Surgery or equivalent Board and have an academic appointment in a Department of Surgery. Data were analyzed using the SPSS program. Two hundred seventy women (age range, 32-70 years) completed the survey (98.9% response rate). Fellowships were completed by 82.3 per cent (223/270), most commonly in surgical critical care. There were 134 (50.2%, 134/367) who had two or more Board certificates, most frequently (46%, 61/134) in surgical critical care. Full-time academic appointments were held by 86.7 per cent of women, most as assistant professors, clinical track; only 12.4 per cent were tenured professors. The majority of women described their practice as "general surgery" or "general surgery with emphasis on breast." The most frequent administrative title was "Director." Only three women stated that they were "chair" of the department. The top reason for choosing surgery was "gut feeling," whereas "intellectual challenge" was the reason they pursued academic surgery. When asked "Would you do it again?", 77 per cent responded in the affirmative. We conclude that female academic surgeons are well trained, with slightly more than half having two or more Board certificates; that most female academic surgeons are clinically active assistant or associate professors whose practice is "general surgery," often with an emphasis on breast disease; that true leadership positions remain elusive for women in academic general surgery; and that 77 per cent would choose the same career again.     

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??Application of fast track surgery in pancreatic surgery : current status and controversies SUN Bei, SONG Zeng-fu, JIANG Hong-chi. Department of Pancreatic and Biliary Surgery, the First Affiliated Hospital of Harbin Medical University, Harbin 150001,China
Corresponding author??SUN Bei,E-mail??sunbei70@tom.com
Abstract In 21th century, with the development of minimally invasive techniques and the change of the medical treatment pattern, patients apply to surgeons for higher demand on postoperative recovery so as to decrease medical costs and reduce length of hospital stay. Meanwhile, fast track surgery (FTS) appeared, which has been applied in many kinds of surgical fields. Recently, the application of FTS has developed rapidly in pancreatic surgery through the joint efforts of all pancreatic surgeons. However, the new concept always comes along with new challenge.     

G. T. 1878-1960: master of language and surgery

Sir Gordon Gordon-Taylor was the pre-eminent British surgeon of the first half of the twentieth century. He became known for his daring cancer surgery which he perfected at the Middlesex Hospital, and he promoted early operation for abdominal gunshot wounds in World War I. During World War II, as a surgeon rear admiral, he was not only an active surgeon in the London region, but he also acted as a significant ambassador for Allied surgery. After the War he was in great demand as an eponymous orator throughout the length and breadth of Great Britain and abroad, and he encouraged many Commonwealth surgeons, particularly those from Australia and New Zealand, to further their training in Britain and then he actively supported them in their later careers. His death following an accident in 1960 was mourned through the surgical world.     

C. Walton Lillehei and the epic of open heart surgery

C. Walton Lillehei (1918-1999) from the Surgery Department of the University of Minnesota in Minneapolis (MN, USA), was the precursor of open heart surgery. He successively introduced heart-lung machine, intracardiac repairs, pacemaker, and mechanical cardiac valves.     

THE PROVISION OF GENERAL SURGICAL SERVICES IN RURAL SOUTH AUSTRALIA: A NEW MODEL FOR RURAL SURGERY

Background : Rural South Australia (SA), like other rural areas in Australia, faces crisis in the medical workforce. It is also generally assumed that the same applies to rural surgical services but finding evidence to support this is scarce. Methods : All hospitals situated outside the outer metropolitan area of SA were surveyed about surgical services (n= 57). Questions were asked about the frequency of emergency and elective theatre usage and which surgeons provided surgical services. Results: Operating theatre facilities were in active use in 39 of the 57 hospitals studied. At the time of the study there were seven specialist general surgeons resident in rural SA. General practitioners continued to have major input in the provision of surgical services, either by providing the general anaesthetic (34/39) or by performing the surgical procedures (26/39). Conclusions : The Department of Surgery at the University of Adelaide is instituting various measures to counter the rural surgical workforce problem and is developing model that serves either the individual or the two–person surgical practice. Metropolitan teaching hospitals can play an important role in supporting current rural surgeons and can foster an increased commitment to the future of rural general surgery.     

You, your patient, and the medical-device industry: applications from my Louisville years

Hiram C. Polk, Jr, M.D.--forever to be known as "The Boss"--is retiring as Chair of the University of Louisville Department of Surgery after 33 years where he directed the training of almost 250 surgeons. I was fortunate to have been one of those. From his first days, Dr. Polk's goal and mission centered on excellence in patient care followed by excellence in surgical education; other issues, although of extreme importance, were well down the list. I did not realize what a profound impact the beliefs and culture of the Louisville experience would have on my professional and academic career. Accordingly, the purpose herein is to dissect those prevailing central themes and beliefs that led to the longevity and consistency of Dr. Polk's success and had such an impact on so many young surgeons. Hopefully, the discerning reader will note the parallelism of doing the right thing whether as a departmental chairman or a practicing surgeon making daily decisions in patient care.     

努力减少甲状腺手术并发症

甲状腺手术是普通外科常见手术,随着手术技巧的提高和新技术的应用,甲状腺手术并发症的发生率较前已大幅度下降。但是,以甲状旁腺和喉返神经损伤为主的手术并发症仍然严重影响疗效并给病人带来身心伤害。减少甲状腺手术并发症重在预防,重视甲状腺手术的基本理念和基础技能、规范合理应用新技术以及专科化培训是减少甲状腺手术并发症的基础和有效措施。     

The John S. Najarian symposium: The past,present, and future of surgery and transplantation,May 20, 2022, Minneapolis,MN

Dr John S Najarian (1927–2020), chairman of the Department of Surgery at the University of Minnesota from 1967 to 1993, was a pioneer in surgery, clinical immunology and transplantation. A Covid-delayed Festschrift was held in his honor on May 20, 2022. The speakers reflected on his myriad contributions to surgery, transplantation, and resident/fellow training, as well as current areas of ongoing research to improve clinical outcomes. Of note, Dr Najarian was a founder of the journal Clinical Transplantation.     

Progress of surgical training in Papua New Guinea to the end of the 20th century

BACKGROUND: Health care in Papua New Guinea (PNG) throughout the 20th century has been characterized by a significant shortage of medical practitioners and surgical expertise. A number of initiatives within the country and from outside have sought to address these deficiencies of numbers and quality. The present paper seeks to review the development of surgery and surgical training in PNG. METHODS: Review of the surgical literature, reports and records in the Division of Surgery at the University of Papua New Guinea (UPNG), and personal observations are used to look critically at the content and productivity of the various training initiatives. RESULTS: For the first half of the century, PNG relied on national medical assistants who were trained, supervised and directed by expatriate doctors. Medical training of PNG doctors began in 1951 and by 1999 more than 600 doctors had graduated. Expatriate specialist surgeons arrived in 1950 and were the only surgeons until the postgraduate Master of Medicine (surgical) programme produced its first graduates in 1978. This programme has now produced 37 surgeons who are reasonably well distributed throughout the country. Higher surgical diplomas were introduced in 1994 for more specialized training of some of the general surgeons. These training developments have been supported by AusAid as well as by Australian surgeons. CONCLUSIONS: Surgical expertise has progressively improved throughout the 20th century with the most major advances being achieved in the last decade. Training programmes have provided an expanding core of expertise of considerable quality, but the numbers of doctors and surgeons remain well below requirements.