YOUR INSPIRATION FOR TODAY :) FAMOUS MEDICAL STUDENT DISCOVERIES: Some medical students sometimes regard themselves as an unimportant, unwanted and superfluous member of the medical team, lacking experience and often finding themselves standing in the way, unsure of what to do when a medical emergency arises. However, an examination of medical history reveals that medical students have been instrumental in contributing to new medical developments and discoveries. Their contributions are a reminder of how meticulous study and hard work in clinical and scientific research can lead to significant achievements on a large-scale. A few examples of significant medical student discoveries include the discovery of heparin as a major anticoagulant, identification of insulin in the control of blood glucose and diabetes management, ether anaesthesia and the discovery of the sinoatrial node. With medical schools worldwide and across Australia increasingly incorporating research programmes into medical curricula, medical students’ contribution to medical innovation will hopefully continue into the future. *********Famous medical student discoveries*************** Diabetes research In 1869, Paul Langerhans (1847-1888) a German medical student from the University of Berlin, studying under the famous pathologist Rudolf Virchow (1821-1902), described pancreatic islets in his thesis, and was also the first to discover and describe dendritic (Langerhans) cells in the skin. [1,2] The exocrine pancreas had been significantly investigated since the 16th century and the organ was regarded as a “salivary gland”. Langerhans began his research on the microscopic anatomy of the pancreas using pancreatic tissue from humans, rabbits and salamanders. He completed his work within 6 months – the length of a modern day medical school research project – identifying the presence of “irregularly polygonal” cells with clear cytoplasm diffusely scattered throughout the gland. Later, the French histopathologist Edouard Laguesse discovered that the pancreatic islets were in fact a source of internal pancreatic secretion, later determined to be insulin. Insulin was later discovered by a Canadian medical student, Charles Herbert Best (1899-1978) and a young surgeon, Frederick Grant Banting (1891-1941). As a 22-year old medical student who had just completed his physiology exams, Best was introduced to the 28-year old medical practitioner and surgeon Banting, by his physiology professor, John JR Macleod. [2] Under Macleod’s research laboratory and with difficult working conditions, Banting and Best were determined to prove their hypothesis that the factors preventing diabetes mellitus were found in the Islets of Langerhans. These cells could be isolated from a dog, after ligating the pancreatic duct, which caused the exocrine pancreas to atrophy. Banting argued that injecting an Islet extract into a diabetic dog would resolve its symptoms. [1] After much failure, they identified a purified pancreatic extract and tested it by intravenous injection into a diabetic dog. Thus, by late 1921 they were able to show insulin’s efficacy in treating canine diabetes. By February 1922 they performed the first human insulin injection to successfully treat Leonard Thompson – a fourteen year-old diabetic who then lived for 13 years (but later died from a motor vehicle accident) with diabetes after initially being expected to live for a few weeks. [2-4] In 1923 Banting and Macleod were awarded with the Nobel Prize and Banting’s prize money shared with Best, who was still a medical student at the time. Anatomy English medical students of the 18th and 19th centuries had an infamous reputation for bodysnatching from graveyards to provide a sufficient numbers of cadavers for their anatomy dissection studies. [5] The study of anatomy and acquisition of cadaveric material is now very different, but these fanatically enthusiastic early medical student pursuits also paved the way for positive discoveries in the fields of anatomy and surgery. Martin Flack (1882-1931) was an English medical student from Kent, who in 1903 started work at the London Hospital with the famous anatomist Sir Arthur Keith (1866-1955). On returning from a holiday Keith was informed by his excited medical student of a “wonderful structure he had discovered in the right auricle of the mole.” [6,7] This discovery of the sinoatrial node was made whilst Flack spent his summer holiday dissecting the hearts of moles, mice and frogs with the same surprising results. The structure he had identified resembled the atrioventricular node and thus they concluded that the sinoatrial node was the cardiac pacemaker – the origin of the “dominating rhythm of the heart.” The pancreaticobiliary sphincter was also a famous discovery made by a 23-year old Italian medical student from the University of Perugia, Ruggero Oddi (1864-1913). Oddi studied the actions of the sphincter and observed that it controlled the flow of bile from the liver into the duodenum. He was also credited with suggesting that sphincter dysfunction was implicated in biliary tract disease. [1] Other influential student discoveries include William Harvey’s observations at the University of Padua that venous valves provided unidirectional blood flow, and the discovery through chick embryos that the heart had an important role in pumping blood via the systemic circulation. [9] Spermatozoa were also similarly discovered by the medical student Johan Hahm (1651-1723) in 1671 after he provided a sample of urethral discharge from a patient with gonorrhoea to the Dutch lensmaker and “father of microscopy” Atoni Van Leeuwenhoek in which he had identified small living “animacules”. [1] Leuwenhoek then studied his own semen, identifying the presence of motile animalcules, with blunt round bodies and thin, undulating transparent tails, which he then proposed was involved in fertilising the ovum. Anticoagulants Heparin is a major anticoagulant used in modern day medical and surgical practice to prevent and treat thromboembolism. This major pharmacological agent was discovered by a second-year medical student from Johns Hopkins University, Baltimore, Jay McLean (1890-1957). McLean worked in a coagulation laboratory under the guidance of the physiologist William Henry Howell, where he was aiming to investigate procoagulants. In 1961 he isolated a fat-soluble phosphatide anticoagulant in canine liver tissue. [1,10] McLean unfortunately did not further pursue this investigation as he was more interested in procoagulants and he moved to Pennsylvania, so Howell continued research on this anticoagulant. This would later be termed heparin (from Greek, hepar for liver) and by 1937 trials of heparin use had commenced, after which heparin was considered a safe and effective anticoagulant. Unfortunately, however, the discovery of heparin was to become a major area of dispute and a posthumous attempt for a Nobel Prize for McLean later failed. Ether anaesthesia While it is argued that the first use of ether anaesthesia for general surgery was byWilliam Crawford Williamson Long (1815-1878), the first recorded administration of ether anaesthesia for dental surgery was performed by a medical student named William E. Clarke in New York, 1842, in which Clarke was assisting a dentist to perform a painless tooth extraction. [11] Long was a young country doctor who is credited to have administered ether to a young man in 1842 for which a painless neck cyst removal was performed. Infectious diseases Even as a first year medical student, Sir James Paget was contributing to significant discoveries. Although he is well-renowned for the eponymous conditions of Paget’s disease of bone (osteitis deformans) and Paget’s disease of the breast and nipple, his name was published as a first-year medical student for discovering the nematode Trichinella spiralisin human muscle, the cause of trichinosis. [12] Similarly, an Argentinian medical student, Alejandro Posadas discovered Coccidioidomycosis in 1892, describing a case report of an Argentinian soldier with cutaneous manifestations of the disease. Later, in 1926 a second medical student, Charles Smith inadvertently contracted the disease by inhaling the spores whilst working on the organism in the laboratory. He later developed pleuritic chest pain and purulent productive cough – which helped identify the clinical presentation of the disease and luckily he survived to tirelessly study the disease throughout his professional career. [13]This list of historical medical student discovery is by no means exhaustive. However, it highlights the influence of medical students on medical research and innovation throughout history. Although current freedom of research may be limited by modern day bureaucracy, students still have chances to contribute to research, through increased university research opportunities. The role of medical schools and research The modern day medical student may question what is left for them to discover, as modern medicine becomes increasingly sub-specialised. The explosion in medical advances over the last few decades makes it daunting to even make a small contribution. A quick internet search may reveal that many ideas have been exhaustively investigated and recent discoveries are only possible in certain areas such as molecular biology. [1] However, with the availability of recent technologies, modern research methods and laboratory techniques, students still have many options available to unleash their creativity and pursue their interests through research. Additionally, mandatory and optional research components have increasingly become part of medical school training programmes, which provide numerous opportunities for students to become involved in working with world-expert researchers, academics and clinicians.
Posted on: Wed, 27 Nov 2013 14:49:18 +0000
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