250 years after Morgagni (1682-1771), author of the masterpiece De Sedibus et Causis Morborum, and his contributions to neurology development / 250 anos depois de Morgagni (1682-1771), autor da obra-prima De Sedibus et Causis Morborum, e de suas contribuições para o desenvolvimento da neurologia

Giovanni Battista Morgagni (1682-1771) is recognized as the father of modern anatomical pathology1. Ten years before his death, 250 years ago, he published his monumental five-volume book De Sedibus et Causis Morborum per Anatomen Indagatis (On the Seats and Causes of Disease)2, which contributed to the current experience in neuroscience. He was one of the pioneers of anatomoclinical method, based on the correlation between the clinic and anatomic lesions, that was essential for neurology development.

GIOVAN BATTISTA MORGAGNI E IL DIBATTITO FRA MEDICINA RAZIONALE E MEDICINA EMPIRICA

Giovanni Battista Morgagni is considered the father of pathological anatomy. His contribution can be contextualized in the extraordinary development of anatomy between the seventeenth and the eighteenth centuries, because along this period anatomy became the most important among the natural sciences. A new pathology based on anatomy was possible thanks to the mechanistic perspective which characterized this science during the seventeenth century, in particular through the work of Marcello Malpighi, whom Morgagni considered as his master. The approach of Malpighi and other ‘iatromechanists’ was widely debated: supporters of mechanisms and empiricism, as well as supporters of the Ancients, or Hippocratic-Galenic medicine, and of the Moderns, or ‘Neoteric’ medicine, were opposed and interlaced. The anatomo-clinical method of Morgagni can be fully understood only by being contextualized within this debate.

Giovanni Battista Morgagni and the Morgagni Hernia

Giovanni Morgagni remains an eminent figure in the field of pathological anatomy. Born in Forli, Italy, he excelled as a child. He entered medical school at the age of 16 years old in Bologna. By the age of 31 he held the chair position at the University of Padua. During his tenure, he discovered many anatomical and pathological findings, with the most widely known discovery being the Morgagni Hernia. Morgagni first described this eponymic hernia in an adult stonecutter during an autopsy. In addition to his many discoveries, his most esteemed written contribution to the field of medicine came in the form of a five-volume book titled De Sedibus et Causis Morborum per Anatomen Indagatis, in which he correlated cadaveric anatomy and symptomatology revealed upon autopsy. He remained on faculty at the University of Padua for over five decades until his death in 1771.

Laparoscopic Concomitant Sleeve Gastrectomy and Repair of a Morgagni Larrey Hernia - Case Report

Anterior diaphragmatic hernias are very rare surgical entities, scarce in symptoms, which occur through openings of the costal and sternal fascicules of the diaphragm. First described by Giovanni Battista Morgagni, in 1769, they are known under many names: Morgagni, Morgagni-Larrey. These hernias can develop in the left hemidiaphragm, right hemidiaphragm or bilateral. The preferred treatment when available is the laparoscopic suture of the defect. We present the case of a 52 years old female patient, with morbid obesity (BMI = 44.10 kg/m²) and Morgagni hernia. Other associated pathologies of the patient were high blood pressure, autoimmune thyroiditis, and sleep apneea. The initial diagnosis of diaphragmatic hernia was made a year earlier at a CT investigation. Laparoscopic sleeve gastrectomy and suture of the diaphragmatic defect were achieved without incidents during one single surgical intervention. A drainage tube was placed in the remaining cavity of the hernia. The hernia sac was conserved and used to reinforce the defect. The concurrent suture of the diaphragmatic hernia and sleeve gastrectomy do not increase the postoperative morbidity. The recovery was uneventful, thus the patient was spared a second surgical intervention . If present, these hernias are quickly identified due to the fact that laparoscopy allows a through exploration of the diaphragm. When diagnosed these defects should be repaired by suture due to the fact that they can cause life threating complications to the patient such as intestinal obstruction or gastro-intestinal bleeding if elements of the digestive tract are incarcerated in the defect.

New data on the immunohistochemical and morphological characteristics of ductal pancreatic adenocarcinoma

In recent years, especially in developed countries, there has been an increase in the incidence of pancreatic cancer. Only 20% of tumors at the time of diagnosis are evaluated as resectable, but in these cases, the prognosis of the disease is unfavorable. The overall 5-year survival rate does not exceed 5%. Pancreatic cancer was described in the 1760s by Giovanni Battista Morgagni in his classic book “De Sedibus et Causis Morborum per Anatomen Indigatis”. Over the next 200 years, pathologists significantly improved our understanding of the macro- and microscopic features of this disease. At the same time, morphological research remained the basis of diagnostics for centuries. The introduction of immunohistochemical studies into clinical practice in the late 1970s and early 1980s radically changed our approach to diagnosing this disease. Evaluation of morphological features, as well as features of expression of markers that determine the invasive potential of such neoplasms, can serve in the future as a fundamental basis in solving questions concerning possible factors of prognosis upon malignant tumors of such a localization. Aim of research — to study the morphological and immunohistochemical features of ductal pancreatic adenocarcinoma. Materials and methods. The study included 84 patients with pancreatic cancer T1-4N0-2M0-1 stage, aged from 37 to 83, who underwent surgical treatment. Morphological study of the operating material was carried out. The condition for inclusion in the study was a histotype of the tumor, namely ductal pancreatic adenocarcinoma. Posting of the material, preparation of histological preparations, coloring, immunohistochemical examination were carried out according to a standard procedure. Results and conclusion. The study made it possible to characterize the tumor morphology, as well as the features of expression of markers associated with more evident invasive characteristics of the tumor. The results of this work may be of interest in terms of their further comparison with the parameters of various forms of progression upon pancreatic cancer.