The discovery of H. pylori and its role in peptic ulcer disease was a collaborative effort between clinicians and scientists at Royal Perth Hospital in Western Australia in the early 1980s. Robin Warren, a pathologist, first observed the bacteria in gastric biopsies. Barry Marshall, an intern, helped cultivate H. pylori from a patient's biopsy, fulfilling Koch's postulates. Together with contributions from electron microscopists, microbiologists, and other specialists, they were ultimately able to characterize the bacteria and its association with gastritis and peptic ulcers. For their seminal work, Warren and Marshall received the 2005 Nobel Prize in Physiology or Medicine.
Helicobacter pylori associated Peptic ulcer diseaseS M Ali Hasan
Evidence-based clinical practice guidelines for H. pylori associated peptic ulcer disease based on
Japanese society of Gastroenterology, 2015
American College of Gastroenterology, 2017
The Maastricht V/Florence Consensus Report, 2018
Helicobacter pylori associated Peptic ulcer diseaseS M Ali Hasan
Evidence-based clinical practice guidelines for H. pylori associated peptic ulcer disease based on
Japanese society of Gastroenterology, 2015
American College of Gastroenterology, 2017
The Maastricht V/Florence Consensus Report, 2018
Laboratory diagnosis of H. Pylori infection, Ola ElgaddarOla Elgaddar
A short presentation for the different laboratory techniques used in diagnosing Helicobacter Pylori infection. A special focus is given for the diagnostic performance of every test.
Irritable Bowel Syndrome: An Update in Pathophysiology and Management Monkez M Yousif
Irritable bowel syndrome is the commonest health problem in hospital outpatient clinics and in private health care facilities and represents a big challenge for patients and physicians. This presentation discusses a different aspect of the disease from pathophysiology, clinical presentation and management
Laboratory diagnosis of H. Pylori infection, Ola ElgaddarOla Elgaddar
A short presentation for the different laboratory techniques used in diagnosing Helicobacter Pylori infection. A special focus is given for the diagnostic performance of every test.
Irritable Bowel Syndrome: An Update in Pathophysiology and Management Monkez M Yousif
Irritable bowel syndrome is the commonest health problem in hospital outpatient clinics and in private health care facilities and represents a big challenge for patients and physicians. This presentation discusses a different aspect of the disease from pathophysiology, clinical presentation and management
Contributions of Various scientist for the development of Microbiology field.
1. Antony Van Leeuwenhoek
2. Edwerd Jenner
3. Louis Pasteur
4. Joseph Lister
5. Robert Koch
6. Paul Ehrlich
7. Alexander Fleming
Microbiology is the study of organisms that are usually too small to be seen by the unaided eye; it employs techniques—such as sterilization and the use of culture media—that are required to isolate and grow these microorganisms.
Description of various ultrasound features of benign and suspicious thyroid nodules with multiple ultrasound systems for risk stratification of malignancy.
Description of different ultrasound features of carpal tunnel syndrome before and after carpal tunnel release including Doppler imaging and elastography
Doppler ultrasound of visceral arteriesSamir Haffar
Doppler ultrasound of different diseases of visceral arteries including arterial stenosis and occlusion, arterial aneurysm, artrial pseudoaneurysm, arterio-venous fistula, artrial dissection, and abdominal vascular compression syndromes
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Helicobacter pylori & Nobel Prize in medicine & physiology
1. H. Pylori & Nobel Prize for Medicine
Samir Haffar M.D.
Assistant Professor of Gastroenterology
2. Giulio Bizzozero (1846 - 1901)
Italian Pathologist
• Desribed for the first time presence of
helicobacters in the stomach of dogs
• Communicated his discovery during
meeting of the Turin Medial Academy
on 18th of March 1892
• Spirilli described by Bizzozzero were
presumably H. beilmannii or H. felis
Figura N et al. In Marshall BJ, ed. Helicobacter pioneers.
Victoria, Australia: Blackwell, 2002.
3. Bizzozero’s drawing
Bacteria live in acid producing cells
These bacteria must be acid tolerant or must turn off acid secretion
Figura N et al. In Marshall BJ, ed. Helicobacter pioneers.
Victoria, Australia: Blackwell, 2002.
4. Investigators who described H. Pylori in
human & mammalian gastric mucosa
Investigators from
- France
- Poland
- Germany
- United Kingdom
- United States
- Greece
- China
- Soviet Union
5. First detailed histological &
ultrastructural on human H. Pylori
• Done by Steer in Southampton in 1975
• Spiral bacteria closely apposed to mucus secreting cells
Bacteria possessed at least one flagellum
• Polymorphonuclear leucocytes migrated through gastric
mucosa, presumably in response to bacteria
• Culture of endoscopic biopsy yielded only
Pseudomonas aeruginosa (not a spiral organism)
Steer HW. J Clin Pathol 1975 ; 28 : 639 – 46.
6. Royal Perth Hospital, Perth, Western Australia
• Histological & ultrastructural studies of the gastric
mucosa had been published in 1979 *
• Spiral bacteria were seen, but because they did not
invade the mucosa were thought to be irrelevant
* Fung WP et al. Am J Gastroenterol 1979 ; 71 : 269 – 79.
7. Robin Warren
Histopathologist – Royal Perth Hospital
• Expert in gastric pathology & bacterial staining in
pathological specimens
• He took notice of these bacteria & correlated them with
presence of polymorphonuclear leucocytes
• He emphasised that stomach must not be viewed as
sterile organ
Warren JR. Lancet 1983 ; I : 1273.
8. Barry Marshall
Registrar in training – Royal Perth Hospital, 1981
• Learning gastroenterology for 6 months
• He reviewed with Warren case notes of pts in whom
large numbers of gastric spiral bacteria had been seen
• One of the patients, with severe epigastric discomfort,
treated fortuitously with tetracycline; symptoms resolved
& subsequent endoscopic biopsy showed antral gastritis
had also resolved
Marshall BJ. In: Blaser MJ, ed. Campylobacter pylori in gastritis
& peptic ulcer disease. New York: Igaku-Shoin, 1989: 7 – 23 .
9. J A Armstrong
Head of electron microscopy unit – Royal Perth Hospital
• Marshall asked him for assistance in 1981
• He & his assistant Wee obtained high magnification
electronmicrographs of bacteria in endoscopic biopsy
• When Warren & Marshall could not agree on wording
of a joint letter to the Lancet in 1983, Armstrong
advised them to write separate letters
10. C S Goodwin
Head of microbiology department – Royal Perth Hospital
• Marshall asked him for assistance in late 1981
• Agreement of a protocol
Gastric biopsy from 100 consecutive patients
Consultant gastroenterologists: Waters & Sanderson
Gram stain & culture
Supervisor: Pearman, microbiologist
Technologists: Kosaras & Royce
Goodwin C S. Gut l993 ; 34 : 293 – 294.
11. The Protocol
Started in March 1982
The first 34 cultures
Spiral bacteria seen in Gram stain in six
Spiral bacteria were not cultured
Incubation was limited to 48 hours
The 35th culture
Incubating during Easter holiday (5 days in Australia)
Pure growth of 1 mm transparent colonies
H. pylori had been finally cultured (14 April 1982)
Goodwin C S. Gut l993 ; 34 : 293 – 294.
12. Results
Among the 100 specimens
• Spiral bacteria seen histologically 58 patients
• Spiral bacteria seen in Gram stain 34 patients
• Culture of the new organism 11 patients
Goodwin C S. Gut l993 ; 34 : 293 – 294.
13. Follow-up
• Gram stain of colonies showed only slightly curved
organisms, not spirals & Marshall doubted whether they
had grown the correct organism
• Armstrong & Wee produced electron micrographs
revealing that bacteria were spiral with 5 sheathed
flagella which proving they were not Campylobacter spp
• Annear achieved lyophylisation of several cultures
Two earliest isolates: NCTC 11637 & NCTC 11638
Goodwin C S. Gut l993 ; 34 : 293 – 294.
14. Marshall – the catalyst of the team
• Rushed not to publish
• Went to library to read new articles & old books
• Consulted experts in bacteriology & gastroenterology
• Realized that gastritis had high association with DU
& only slightly less so with GU
• Devised selective media for primary isolation
• Discovered HP sensitivity to bismuth & metronidazole
Marshall BJ et al. Med J Aust 1985 ; 142 : 439 – 44.
15. First publications of Marshall & Warren
• Letters
- Warren JR. Unidentified curved bacilli on gastric epithelium
in active chronic gastritis. Lancet 1983; i: 1273.
- Marshall B. Unidentified curved bacilli on gastric epithelium
in active chronic gastritis. Lancet 1983; i: 1273-4.
• Original article
Marshall BJ, Warren JR. Unidentified curved bacilli in stomach
of pts with gastritis & peptic ulceration. Lancet 1984; i: 1311-4.
16. Name of the bacteria
• Skirrow (1993) 1
Suggested the name Campylobacter pyloridis
• Marshall et all (1984) 2
Formally proposed the name C pyloridis
Rules of Latin grammar required to change it to C pylori
1 Proceedings of Second International Workshop on Campylobacter infections. London:
Public Health Laboratory Service, 1983 : 33 – 8.
2 Marshall BJ et al. Microbios Lett 1984 ; 25 : 83 – 88.
17. Robert Koch (1843 – 1910)
Discovered
Anthrax disease cycle - 1876
Bacteria of TB - 1882
Bacteria of cholera - 1883
Formulated
Koch’s Postulate -refined in 1884)
Award
Nobel prize for medicine 1905
18. Koch's postulates
Causal relationship between a microbe & a disease
Microorganism must be present in every case of disease
Microorganism must be isolated from diseased
organism & grown in pure culture
Cultured microorganism should cause disease when
introduced into a healthy organism
Microorganism must be recoverable from experimental
infected host
Koch R. J Hyg Inf 1893 ; 14 : 319 – 333.
19. Marshall's stomach biopsy
Marshall BJ et al. Attempt to fulfill Koch's postulates for Campylobacter Pylori.
Med J Aust 1985; 142 : 436 – 439.
Silver stain of HP on gastric epithelial cells (x1000)
Marshall's stomach biopsy taken 8 days after he drank culture of HP
20. New Name for Helicobacter Pylori
Unlikely to change the name again
• 1985
Goodwin studied cellular fatty acids of C Pylori
Discover unique profile which indicated new genus 1
• 1989
Sufficient evidence to justify new genus
Goodwin devised the name Helicobacter
So we now have H. pylori 2
1 Goodwin CS et al. J Med Microbiol 1985 ; 19 : 257 – 67.
2 Goodwin CS et al. Int J Syst Bacteriol 1989 ; 39 : 397 – 405.
21. Helicobacter pylori
HP Smooth wall
4–7 sheathed flagella arising from one end of cell
Campylobacter Rough cell walls
Single thinner flagellum at each end of cell
23. Teamwork, between four departments, was
the secret of the first successful culture, in
Royal Perth Hospital, Western Australia, of
human gastric spiral bacteria, now called
Helicobacter pylori.
24. Was the culture of H. Pylori an accident?
• Some said that it was an accident
• They were fortunate in Perth that a five-day Australian
holiday occurred during the project
• This proved what Louis Pasteur said:
“chance favors only the prepared mind”
25. Louis Pasteur (1822 – 1895)
“Chance favors only the prepared mind ”
“Dans les champs de l’observation, le hasard
ne favorise que les esprits préparés”
30. Why previous investigators didn't recognize HP?
• In his chapter in Helicobacter Pioneers, Warren says
it would have been very difficult even one decade
earlier to make observations that he & Marshall made
• He mentions in particular the advent of:
Fiberoptic endoscopy
Gastric tissue obtained from autopsy or surgery
Samples autolyzed before pathological examination
Electron microscopy
Define way in which HP attached to gastric epithelium
Marshall BJ, ed. Helicobacter pioneers. Victoria, Australia: Blackwell, 2002.
31. H. pylori is one of the most studied
organisms in medicine:
More than 22,000 relevant articles have
been listed in PubMed from 1983 to 2005
* Parsonnet J. N Eng l J Med 2005 ; 353 : 2421 – 2423.
32. Co-Winners of Nobel Prize in 2005
for their discovery of HP
Barry Marshall & Robin Warren
33. Warren & Marshall receiving the Nobel Prize
from the King Carl XVI Gustaf of Sweden
Stockholm Concert Hall, 10 December 2005
34. Press release of the Nobel committee
• Acknowledged the “prepared mind(s)” & tenacity”
of the new laureates as keys to their success
• Unlike Louis Pasteur, the committee neglected to
mention luck
Parsonnet J. N Eng l J Med 2005 ; 353 : 2421 – 2423.
35. Nobel Prize for clinicians
At the time of Warren & Marshall’s discovery
• They were physicians doing their daily jobs
• They were not in laboratory chasing after Nobel Prize
• They had no intention of being in the limelight
• They had no research grants for studying ulcer disease
• They happened upon something interesting, & driven by
curiosity, they investigated & reported it
Parsonnet J. N Eng l J Med 2005 ; 353 : 2421 – 2423.
Editor's Notes
In spite of frequent variations of media, and temperatures of incubation, from these 34 specimens, however, spiral bacteria were notcultured, because incubation was limited to 48 hours.
Bacteriologist Robert Koch discovered the anthrax disease cycle (1876); and the bacteria responsible for tuberculosis (1882) and cholera (1883). Koch formulated rules for the control of epidemics of cholera. "Koch's Postulates" (Kochsche Postulate, refined in 1884) are still the basic procedures used by modern epidemiologists and medical researchers: (1) Identify a specific organism, (2) obtain a pure culture of that organism, (3) reproduce the disease in experimental animals using the pure culture, and (4) recover the organism from the infected animals. Robert Koch Robert Heinrich Hermann Koch Born:11-Dec-1843Birthplace:Clausthal-Zellerfeld, GermanyDied:27-May-1910Location of death:Baden-Baden, GermanyCause of death: Heart FailureRemains: Cremated, Robert Koch Institute, Berlin, GermanyGender: MaleRace or Ethnicity: WhiteSexual orientation: StraightOccupation:DoctorNationality: GermanyExecutive summary: Discovered bacteria that causes tuberculosis Wife: Emmy AdolfineFraats (m. 1866)Daughter: Gertrud (b. 1865)Wife: Hedwig Freiberg (m. 1893)University: University of Göttingen (1866)Professor: University of BerlinNobel Prize for Medicine 1905
Koch's postulates (or Henle-Koch postulates) are four criteria designed to establish a causal relationship between a causative microbe and a disease. The postulates were formulated by Robert Koch (German physician & bacteriologist ) and Friedrich Loeffler in 1884 and refined and published by Koch in 1890. Koch applied the postulates to establish the etiology of anthrax and tuberculosis, but they have been generalized to other diseases.However, Koch abandoned the second part of the first postulate altogether when he discovered asymptomatic carriers of cholera[1] and, later, Typhoid Mary. Asymptomatic carriers are now known to be a common feature of many infectious diseases, especially viruses such as polio, herpes simplex, HIV and hepatitis C. As a specific example, all doctors and virologists agree that poliovirus causes paralysis in just a few infected subjects, and the success of the polio vaccine in preventing disease supports the conviction that the poliovirus is the causative agent.The third postulate specifies "should", not "must", because as Koch himself proved in regard to both tuberculosis and cholera, not all organisms exposed to an infectious agent will acquire the infection. This may be due to chance, to acquired immunity, or to genetic immunity. An example of genetic immunity: human immunodeficiency virus (HIV) seems to be normally unable to infect persons who carry the deletion CCR5 Δ32.
A silver stain (Warthin Starry) of HP (black wiggly things) on gastric mucus-secreting epithelial cells (x1000). This picture is notorious because it is of Dr. Marshall's stomach biopsy taken 8 days after he drank a culture of H. pylori. The experiment was published in 1985 (Marshall BJ, Armstrong JA, McGechie DB, Glancy RJ. Attempt to fulfill Koch's postulates for pyloric Campylobacter. Med J Aust 1985; 142: 436-439).
Helicobacter pylori (3.5 × 0.6 μm) has a smooth wall and four to seven sheathed flagella arising from only one end of the cell.These features distinguish it from Campylobacter spp., which have rough cell walls and a single, thinner, unsheathed flagellum at each endof the cell. Other Helicobacter spp. have distinguishing features such as many flagella and axial filaments (H. felis from cats) or flagella sprouting from the sides of the organism (H. mustelae from ferrets). Mature organisms appear as spiral forms with 1.5 wavelengths.
Barry J. Marshall receiving his Nobel Prize from His Majesty the King Carl XVI Gustaf of Sweden at the Stockholm Concert Hall, 10 December 2005.