Eponyms

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Finkelstein’s Test

Other Known Aliases – Eichoff’s test

Definition – physical examination maneuver that is used to diagnose de Quervain’s tenosynovitis.

Clinical Significance – this maneuver is performed by deviating the wrist in the ulnar direction while pushing the thumb towards the palm. A positive illicits pain along the radial aspect of the wrist along the abductor pollicis longus and extensor pollicis brevis tendons.

History – Named after Henry Finkelstein (1883-1975), who was an American surgeon and recieved his medical doctorate from the College of Physicians and Surgeons in 1904. He would go on to have a modest career in orthopaedic surgery serving as a consultant at Beth Israel Hospital and chief of orthopaedic surgery at Trinity Hospital in Brooklyn, NY. He also was one of the original founding staff of the Hospital for Joint Diseases (now known as NYU Langone Orthopaedic Hospital). He published his eponymous maneuver in a manuscript entitled “Stenosing tendovaginitis at the radial styloid process” in 1930.

References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Up To Date. www.uptodate.com
  6. Finkelstein H. Stenosing tendovaginitis at the radial styloid process. The Journal of Bone and Joint Surgery, 1930, 12: 509-540 [link]
  7. https://www.nytimes.com/1975/01/25/archives/dr-harry-finkelstein-91-orthopedic-surgeon-dies.html

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Ghon Focus and Complex

Other Known Aliases – none

Definition – radiographic finding in primary tuberculosis where cellular and biochemical reaction to the infection forms a nodular granulomatous structure (focus) which can enlarge and invade adjacent lymphatics and hilar lymph nodes (complex).

Clinical Significance – this finding on radiography is pathognomonic for primary active tuberculosis

History – Named after Anton Ghon (1866-1936), who was an Austrian pathologist and recieved his medical doctorate from the University of Graz in 1890. He would spend his entire career in pathology and bacteriology culminating in full professorship at the University of Prague in 1910. He frist published his eponymous findings in his 1912 work entitled “Der primäre Lungenherd bei der Tuberkulose der Kinder”. Unfortunately, we would go on to die from tuberculous pericarditis in 1928

References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Up To Date. www.uptodate.com
  6. Der primäre Lungenherd bei der Tuberkulose der Kinder. Berlin & Wien, Urbach & Schwarzenberg, 1912.
  7. Ober WB. Ghon but not forgotten: Anton Ghon and his complex. Pathol Annu. 1983; 18 Pt 2:79-85. [pubmed]

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Cheyne-Stokes Respirations

Other Known Aliases – none

Definition – oscillating, crescendo-decrescendo pattern of progressive deeper and faster breathing followed a gradual decrease culminating in a period of apnea

Clinical Significance – this pattern is theorized to be a delay in changes to ventilation after detection of PaCO2 changes. This lag causes the classic respiratory pattern. Conditions associated with this include cardiac disease, neurologic disease, sedation, acid-base disturbances, prematurity in infancy, and rapid altitude changes.

History – Named after John Cheyne (1777-1836) , who was a British surgeon and received his medical doctorate at the age of 18 from Edinburgh University. He would serve as a military surgeon for several years before joining his father’s medical practice and ultimately, moving to Dublin for the majority of his career. Some have credited him as “The Father of Medicine in Ireland”. He would describe his eponymous findings in his 1818 article entitled ” A case of apoplexy in which the fleshy part of the heart was converted to fat”

William Stokes (1804-1878), was an Irish physician and received his medical doctorate from the University of Edinbugh in 1825. He was a leader and pioneer in the adaptation of the Parisian school of anatomical diagnosis and helped introduce the stethoscope to clinical practice in Ireland. He would note his eponymous findings in his 1854 textbook entitled ” The Diseases of the Heart and Aorta” and cited Dr. Cheyne as observing this first.

References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Up To Date. www.uptodate.com
  6. Cheyne J. A case of apoplexy in which the fleshy part of the hear was converted into fat. Dubin Hospital Records. 1818;2:216-223. [link]
  7. Stokes W. The Diseases of the Heart and the Aorta. 1954. Dublin. [link]

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Light’s Criteria

Other Known Aliases – none

Definition – set of laboratory findings in pleural effusions that helps differentiate the fluid as transudative or exudative

Clinical Significance – after performing a diagnostic thoracentesis, the fluid can be sent to the lab for biochemical analysis. The results of this analysis can tell the medical team the whether the fluid is transudative or exudative, which can narrow down the causes and provide a diagnostic schema for management.

History – Named after Richard W. Light, a practicing pulmonologist from Vanderbilt University in Nashville, TN. He received his medical doctorate from Johns Hopkins University in 1968 and completed his residency and fellowship there in 1972. He would spend the next 20 years at UC-Irvine building his international reputation as an expert on pleural diseases. He is the author and editor for 16 current textbooks, including the gold standard textbooks Pleural Diseases and The Textbook of Pleural Diseases, as well as authored more than 450 peer reviewed articles. His eponymous criteria were first introduced in 1972 in an article he published as a fellow in the Annals of Internal Medicine….his very first paper as a physician.

References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Up To Date. www.uptodate.com
  6. Light RW, Macgregor MI, Luchsinger PC, Ball WC Jr. Pleural effusions: the diagnostic separation of transudates and exudates. Ann Intern Med. 1972; 77(4):507-13. [pubmed]
  7. Biography of Richard Light. https://respiratory.annualcongress.com/ocm/2019/richard-w-light-vanderbilt-university-nashville
  8. Newman JH. Giants in chest medicine: Richard W. Light, MD. Chest. 2014; 146(5):1152-1154. [pubmed]

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Roux-en-Y Anastomosis

Other Known Aliases – end-to-end surgical anastomosis

Definition – gastrointestinal tract is divided into two limbs (proximal, Roux limb and a distal limb) and are re-anastomosed farther down the GI tract, typically in the jejunum

Clinical Significance – this type of surgery is the traditional form of gastric bypass, where the proximal, Roux limb serves as the food reservoir and somach and the distal limb allows for physiologic drainage of gastric, hepatic, and pancreatic enzymes to aid in digestion. Other conditions it can be used is are chronic pancreatitis, alkaline gastritis, and various GI substitution procedures.

History – Named after César Roux (1857-1934), who was a Swiss surgeon and received his medical doctorate from the University of Bern 1880. He would stay on at his alma mater and assist Theodor Kocher until 1887, when he became chief of surgery at cantonal hospital of Lausanne. He would go on to have a modest career in surgery notable for two historical accomplishments. In 1893, he performed his eponymous procedure on a patient with gastric strictures from peptic ulcer disease to alleviate his obstruction symptoms. In 1926, the year of his retirement, he was the first surgeon to successfully remove a pheochromocytoma….7 months before Charles Mayo performed the same operation in the United States. Harvey Cushing visited his clinic in 1900 and said “he is a rough diamond-looks like Kipling-does excellent work and comes nearer to being the kind of man I am looking for than anyone else I have seen”.

References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Up To Date. www.uptodate.com
  6. C. Roux. De la gastroenterostomie. Revue de chirurgie, 1893, 13: 402-403.
  7. Hutchison R, Hutchinson AL. César Roux and His Original 1893 Paper. Obesity Surgery. 2010;20;953-956 [link]

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Whipple Procedure

Other Known Aliases – pancreaticoduodenectomy

Definition – pancreaticoduodenectomy cholecystectomy, choledochojejunostomy, pancreaticojejunostomy, and gastrojejunostomy

Clinical Significance – this type of surgery is performed to resect pancreatic head tumors. It generally performed at large, high-volume medical centers as this has been shown to reduce mortality to less than 5%. An experienced surgeon can complete this surgery in < 6 hours with < 500mL of blood loss. Barring any postoperative complications, most patients are discharged from the hospital in 7-10 days.

History – Named after Allen Oldfather Whipple (1881-1963), who was an American surgeon and received his medical doctorate from Columbia University College of Physicians and Surgeons in 1908. He was appointed faculty at Columbia and Presbyterian Medical Centers before going on to become professor of surgery at his alma mater for the next 25 years. He published the report of his eponymous surgery in 1935 and only performed it 37 times in his lifetime. He also supervised Virginia Apgar and advised her to pursue a career in anesthesiology because he saw an “energy and ability to make significant contributions” that would advance both fields. Other notable accomplishments include helping establish the American Board of Surgery and establishing another eponymous diagnostic triad for insulinoma.

References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Up To Date. www.uptodate.com
  6. Whipple AO, Parsons WB, Mullins CR. TREATMENT OF CARCINOMA OF THE AMPULLA OF VATER. Ann Surg. 1935; 102(4):763-79. [PDF]
  7. Johna S. Allen Oldfather Whipple: A Distinguished Surgeon and Historian Dig Surg. 2003; 20(2):154-162. [link]

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Heller Myotomy

Other Known Aliases – none

Definition – Ligation of the external muscle fibers of the lower esophageal sphincter

Clinical Significance – this type of surgery can be open, laparoscopically, or endoscopically and is used to treat achalasia by relieving the constriction of the lower esophageal sphincter and allowing food to pass into the stomach. This is often combined with a Nissen fundoplication to prevent reflux after.

History – Named after Ernst Heller (1877-1964), who was a German surgeon and received his medical doctorate from the University of Leipzig. He would serve as a military surgeon during the first World War from 1914-1918 before returning to Leipzig as chief surgeon of Saint George County Hospital. He had a fairly prestigous career in academic surgery, publishing over 80 scientific papers during his career and culminating as Professor of Surgery at the University of Leipzig in 1949. It was in 1913, as an assistant professor to Erwin Payr, that he performed his eponymous procedure on 39yo man with achalasia. He would publish this case report in 1914 and followed this patient for 7 years tracking his progression and documenting his now disease free condition.

References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Up To Date. www.uptodate.com
  6. Heller E. Extramukose Cardiaplastik beim chronischen Cardiospasmus mit Dilatation des Oesophagus. Mitt GrenzgebMed Chir. 1914;27:141–149.
  7. Andreoll NA, Lope LR, Malafai O. Heller’s myotomy: a hundred years of success! Arq Bras Cir Dig. 2014; 27(1):1-2. [PDF]
  8. Haubrich WS. Heller of the Heller Myotomy Gastroenterology. 2006; 130(2):333. [link]
  9. Payne W. Heller’s contribution to the surgical treatment of achalasia of the esophagus The Annals of Thoracic Surgery. 1989; 48(6):876-881. [link]

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Nissen Fundoplication

Other Known Aliases – none

Definition – wrapping of the fundus of the stomach around the lower esophagus to re-enforce the LES and prevent esophageal sliding.

Clinical Significance – this type of surgery can be performed open or laparoscopic to treat GERD with a hiatal hernia when medical management fails. Traditionally, a Nissen is a complete 360-degree wrap, and there are several variations of this procedure that involve incomplete wrapping on various sides of the esophagus.

History – Named after Rudolph Nissen (1896-1981), who was a Jewish-German surgeon who received his medical doctorate from the University of Freiburg in 1921. His medical studies were interrupted by the first World War where he served on the front lines in a medical corp. It was during his service where he would suffer a gunshot to the lung, which would plague him for the rest of his life. He would go on to serve in various surgery departments in Munich, Berlin, and Istanbul where he would become the head of the surgery department in 1933. It was here that he resected an esophageal ulcer from a 28yo patient that required him to remove portion of the lower esophageal sphincter in the process. He decided to wrap a portion of the stomach around the lower esophagus to strengthen the sphincter and the patient reported greatly improved reflux symptoms. It wasn’t until 1955 when he reflected on this case and performed the procedure on two patients for reflux esophagitis and published the results in 1956. Of note, he also operated on Albert Einstein in 1948 to wrap his AAA with cellophane (which was the treatment at the time).

References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Up To Date. www.uptodate.com
  6. Nissen R. [A simple operation for control of reflux esophagitis]. Schweiz Med Wochenschr. 1956;86(Suppl 20):590-2.
  7. Ellis Jr., FH. The Nissen Fundoplication. Ann Thorac Surg. 1992;54:1231-1235.

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Special thanks to Morgan Bechtle, PA-S, 2nd year clinical student from the Drexel University PA Program, who did the leg work on this eponym

APGAR Score

Other Known Aliases – none

Definition – medical rating system used to evaluate the condition of a newborn immediately after birth.

Clinical Significance – first presented in 1952, it is a method for evaluating the status of a newborn and it’s response to resuscitation immediately after birth. It consists of five major criteria-heart rate, respiratory rate, muscle tone, reflex response, and color- which are observed and given a score of 0, 1, or 2 points. Today the test is performed at one minute and five minutes after birth. Neonates with a score of 7-10 generally require no further intervention, with lower scores indicating the possible need for assisted respiration.

History – Named after Virginia Apgar (1909-1974), who was a doctor at New York-Presbyterian and the first woman to become a full professor at Columbia University College of Physicians and Surgeons. She spent most of her career studying obstetrical anesthesia and its effect on the newborn. As a young doctor, Apgar was appalled by the treatment of premature, apneic babies. The practice at the time was to list apneic or malformed newborns as stillborn and place them out of sight to die. Outraged by this practice, Dr. Apgar developed a method that would ensure the observation and documentation of the true condition of each newborn during the first minute of life. The Apgar score was first published in 1953 in a paper titled “A Proposal for a New Method of Evaluation of the Newborn Infant” in which she highlighted the need for a “grading system of newborn infants [that can be used] as a basis for discussion and comparison of obstetric practices, types of maternal pain relief, and the effects resuscitation”. Later, her research went on to show that lower Apgar scores are associated with higher neonatal morbidity and mortality.

References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Up To Date. www.uptodate.com
  6. Changing the face of medicine. U.S. National Library of Medicine. Retrieved from https://cfmedicine.nlm.nih.gov/physicians/. Updated June 3, 2015. Accessed May 23, 2020.
  7. McKee-Garrett, T. Overview of the routine management of the healthy newborn infant. UpToDate. Retrieved from https://www.uptodate.com/contents/overview-of-the-routine-management-of-the-healthy-newborn-infant?search=apgar%20score&sectionRank=1&usage_type=default&anchor=H3&source=machineLearning&selectedTitle=1~53&display_rank=1#H3. Updated May 15, 2020. Accessed 26, 2020.
  8. Fernandes, C. Neonatal resuscitation in the delivery room. UpToDate. Retrieved from https://www.uptodate.com/contents/neonatal-resuscitation-in-the-delivery-room?search=apgar%20score&topicRef=5068&source=see_link#H2429918249. Updated April 10, 2020. Accessed May 26, 2020.
  9. Apgar score: Signs and definitions. Anesthesiology. 2005 April; 102: 885-857. Retrieved from https://anesthesiology.pubs.asahq.org/article.aspx?articleid=1942027.
  10. It happened here: The Apgar score. New York-Presbyterian. Retrieved from https://healthmatters.nyp.org/apgar-score/. Accessed May 26, 2020.
  11. Apgar, virginia. A Proposal for a new method of evaluation of the newborn infant. Current Researches in Anesthesia and Analgesia 32 (1953): 260-267. https://profiles.nlm.nih.gov/spotlight/cp/catalog/nlm:nlmuid-101584647X152-doc. Accessed May 30, 2020. 
  12. Finster M, Wood M. The Apgar score has survivied the test of time. Anesthesiology. 2005 April; 102: 885-857. https://anesthesiology.pubs.asahq.org/article.aspx?articleid=1942027
  13. Library of Congress, Prints and Photographs Division, New York World Telegram & Sun Collection. Retrieved from https://cfmedicine.nlm.nih.gov/physicians/biography_12.html.9.       The Mount Holycoke College Archives and Special Collections. Retrieved from https://cfmedicine.nlm.nih.gov/physicians/biography_12.html.

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Frégoli Delusion

Other Known Aliases – delusion of doubles

Definition – mistaken belief that some person currently present in the deluded person’s environment (typically a stranger) is a familiar person in disguise.

Clinical Significance – to the patient, the stranger is believed to be psychologically identical to this known person (who is not present) even though the deluded person perceives the physical appearance of the stranger as being different from the known person’s typical appearance. There are 4 subtypes:

History – this syndrome was first published in 1927 by Courbon and Fail who describe a case of a young woman who believed she was being pursued by two Parisian actresses in disguise. They named this delusional syndrome after Leopoldo Frégoli, who was an Italian stage actor with an extraordinary ability to impersonate and mimic others on stage.

References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Up To Date. www.uptodate.com
  6. Langdon, R., Connaughton, E. and Coltheart, M. The Fregoli Delusion: A Disorder of Person Identification and Tracking. Top Cogn Sci. 2014;6:615-631.
  7. Courbon, P., & Fail, G. (1927). Syndrome d”‘illusion de Frégoli” et schizophrénie [Syndrome of the “illusion of Fregoli” and schizophrenia]. Bulletin de la Société Clinique de Médecine Mentale, 20, 121–125