Ep-PAINE-nym



Le Fort Fractures

Other Known Aliasestransfacial fracture of the midface

DefinitionThese fractures involve the maxillary bone and are graded based on their direction and involvement of surrounding structures. The key distinguishing feature of this type of fracture is separation of the pterygoid plates from the maxillary sinuses.

Clinical Significance Continuity of the pterygoid plates is essential for midface structural stability and any disruption requires surgical fixation. There are three types of Le Fort fractures:

  1. Type I – Horizontal fracture – involves the lateral bony margin of the nasal opening
  2. Type II – Pyramidal fracture – involves the inferior orbital rim
  3. Type III – Transverse fracture – involves the zygomatic arch, vomer, and across the orbital floor and walls

HistoryNamed after René Le Fort (1869-1951), who was a French surgeon and received his medical doctorate at the age of 21 while serving in the French military. He taught and practice in Lille, France for the majority of his career. He served his country numerous times when called to serve as a military physician, as well as coming out of retirement during World War II to teach at the University of Lille to replace colleagues called to the war effort. He published the findings of his eponymous conditions in 1901 in a treatise entitled “Étude expérimentale sur les fractures de la mâchoire supérieure”, where he described his experiments of dropping cannon balls from varying directions and heights on the faces of cadavers to describe the predictable injury patterns


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. Gartshore L. A brief account of the life of René Le Fort. The British journal of oral & maxillofacial surgery. 2010; 48(3):173-5. [pubmed]
  7. Patterson R. The Le Fort fractures: René Le Fort and his work in anatomical pathology. Canadian journal of surgery. Journal canadien de chirurgie. 1991; 34(2):183-4. [pubmed]
  8. Le Fort R. Étude expérimentale sur les fractures de la machoire supérieure. Revue de chirurgie, Paris 1901; 23: 208-27; 360-79; 479-507

Ep-PAINE-nym



Lemierre Syndrome

Other Known Aliasesseptic phlebitis

Definitioninfectious thrombophlebitis of the internal jugular vein.

Clinical Significance Often this starts out as a simple oropharyngeal infection, but if it goes untreated, it can quickly spread to the deep spaces of the neck and infiltrate the carotid sheath. Septic emboli can travel the body and cause severe bacterial complications, resulting in a mortality of up to 15%. The common pathogen for this condition is Fusobacterium necrophorum.

HistoryNamed after André-Alfred Lemierre (1875-1956), who was a French bacteriologist and received his medical doctorate in 1904. He became Médicine de Hôpitaux (hospitalist) in 1912 and later worked at the famed Hôspital Bischat. He was promoted to professor of microbiology in 1926 due to his work on septicemia, typhus, and GI/GU infections. It was in 1936 when he published a case series in The Lancet describing his eponyomous disease.


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. EM Docs. Lemierre’s Syndrome. http://www.emdocs.net/em-in-5-lemierres-syndrome/
  7. Lemierre AA. On certain septicaemias due to anaerobic organisms. Lancet. 1936;227(5874):701-703. [link]

Ep-PAINE-nym



Swan-Ganz Catheter

Other Known Aliasespulmonary artery catheter

Definitionintravenous catheter that is maneuvered through the right side of the heart into the pulmonary artery.

Clinical Significance This catheter can directly measure several important hemodynamic variables in critical illness:

  • right atrial pressures
  • right ventricular pressures
  • pulmonary artery pressures
  • left atrial filling pressures (wedge pressure)
  • cardiac output/cardiac index
  • systemic vascular resistance
  • pulmonary vascular resistance

It is “floated” through the right side of the heart using the flow of the blood to carry it into the pulmonary artery. This migration has a very characteristic pressure pattern to know where the catheter is in the vascular system.

HistoryNamed after two physicians from Cedars-Sinai Medical Center, Jeremy Swan (1922-2005), an Irish American cardiologist, and William Ganz (1919-2009), a Slovak American cardiologist. Dr. Swan received his medical doctorate from Castleknock College and went on to become faculty at the Mayo Clinic before joining the faculty at Cedars-Sinai Hospital in Los Angeles. Dr. Ganz attended Charles University School of Medicine in Prague in 1938, but was closed in 1940 after the Nazi occupation of Czechoslovakia. Being jewish, he was then sent to a Hungarian Nazi labor camp and was actually scheduled to be sent to Auschwitz in 19944 before his escape. After hiding and waiting out the war, Dr. Ganz returned and graduated from Charles University in 1947 at the top of his class. He practiced in communist Czechslovakia until 1966 when he secretly defected to the US with his wife and sons. His first and only position as a physician in the US was at Cedars-Sinai Hospital, where he met Dr. Swan who got the idea of the catheter from watching the wind play with the sails of boats in the marina. Dr. Ganz had already published research on the use of thermodilution as a way to measure cardiac output and in 1970, they published their landmark article in the NEJM. It should be noted that German surgeon Werner Forssmann first demonstrated the safety of this type of catheter, by doing it on himself in 1929.


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. Swan HJ, Ganz W, Forrester J, Marcus H, Diamond G, Chonette D. Catheterization of the heart in man with use of a flow-directed balloon-tipped catheter. The New England journal of medicine. 1970; 283(9):447-51. [pubmed]
  7. FRONEK A, GANZ V. [Local thermodilution method of measuring minute volume and circulation rate in the peripheral vessels]. Ceskoslovenska fysiologie. 1959; 8(3):189. [pubmed]
  8. W. Forssmann. Die Sondierung des Rechten Herzens. Klinische Wochenschrift, Berlin, 1929, 8: 2085.

Ep-PAINE-nym



Osborn Wave

Other Known AliasesJ-wave, camel-hump, hypothermic hump

Definitionpositive deflection occurring at the junction between the QRS complex and ST segment, commonly referred to as the J point

Clinical Significance Osborn waves are classically seen in hypothermia with a core body temperature < 32°C (90°F), but also can be present in severe hypercalcemia, traumatic brain injury, and pericarditis. It is usually most prominent in the precordial leads.

NEJM. 2015

HistoryNamed after John J. Osborn (1917-2014), who was an American intensivist, and received his medical doctorate from Johns Hopkins University in 1943. He completed a nine-month residency in pediatrics before serving as an Army medical officer in World War II in the Pacific Theatre. He first published his preliminary animal research on hypothermia in 1943 before his military service, and picked it back up after returning stateside. He practiced from New York University to Stanford University and was a founding member of the Society of Critical Care Medicine. His research fostered the initial golden age of intensive care medicine and he worked on heart-lung machine designs, as well as hemodynamic monitoring devices. His eponymous paper was published in 1953 entitled “Experimental hypothermia; respiratory and blood pH changes in relation to cardiac function”


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. OSBORN JJ. Experimental hypothermia; respiratory and blood pH changes in relation to cardiac function. The American journal of physiology. 1953; 175(3):389-98. [pubmed]
  7. Partin C. Profiles in Cardiology: John J Osborn. Clin Cardiol. 1998;21;66-68 [link]

Ep-PAINE-nym



Ottawa Rules

Other Known Aliasesnone

DefinitionSet of clinical decision instruments to help predict pretest probability in various injuries and need for further radiographical studies

Clinical Significance There are four Ottawa Rules clinical decision instruments that are currently used:

  • Knee
  • Foot and Ankle
  • Cervical Spine
  • Head CT in mild head injury

HistoryNamed after The Ottawa Hospital Research Institute and the University of Ottawa over series of publications from 1992-2001. These publications have been validated numerous times and shown to decrease health care costs, unnecessary radiographic studies, and decrease throughput time in the emergency department. The brain behind these studies is Ian Stiell, a Canadian physician researcher who received his medical doctorate from the University of Ontario and completed his residency at McGill University. With over 370 publications to his name, he is a powerhouse in the realm of emergency medicine research.


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. Stiell IG, Wells GA, Vandemheen KL, et al. The Canadian C-spine rule for radiography in alert and stable trauma patients. JAMA. 2001; 286(15):1841-8. [pubmed]
  7. Stiell IG, Greenberg GH, Wells GA, et al. Derivation of a decision rule for the use of radiography in acute knee injuries. Annals of emergency medicine. 1995; 26(4):405-13. [pubmed]
  8. Stiell IG, Greenberg GH, McKnight RD, Nair RC, McDowell I, Worthington JR. A study to develop clinical decision rules for the use of radiography in acute ankle injuries. Annals of emergency medicine. 1992; 21(4):384-90. [pubmed]

Ep-PAINE-nym



Mallory-Weiss Syndrome

Other Known Aliasesgastro-esophageal laceration syndrome

Definitionlongitudinal mucosal lacerations in the distal esophagus and proximal stomach often leading to bleeding from submucosal arteries

Clinical Significance These tears often occurs as a result of forceful vomiting and can present with hematemesis or melena. Risk factors include alcohol abuse, hiatal hernias, and bulemia. In contrast to Boerhaave’s syndrome, this only involves the mucosa and submucosa and therefor, is not a full thickness rupture. Diagnosis is made via endoscopy and treatment depends on how active the bleed is at the time of endoscopy.

HistoryNamed after two physicians, George Kenneth Mallory (1900-1986) and Soma Weiss (1898-1942), from Boston. Dr. Mallory received his medical doctorate from Harvard Medical School in 1926 and followed in his father’s footsteps by working at the Mallory Institute of Pathology at Boston City Hospital. Dr. Weiss studied physiology and biochemistry in Budapest before immigrating to the United States immediately after World War I, when he wualified in medicine in 1923. He started his career at Cornell before moving to Harvard Medical School, and finally becoming physician-in-chief and professor at The Brigham Hospital in 1939. They partnered and co-authored the manuscript with their eponymous name in 1929, where they described 15 cases of severe, painless hemorrhage of the esophagus preceded by vomiting in alcoholics. They followed this up in 1932 with an additional 6 cases.


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. Mallory GK, Weiss A. Hemorrhages from lacerations of the cardiac orifice of the stomach due to vomiting. American Journal of the Medical Sciences. 1929; 178: 506-15
  7. Weiss S, Mallory GK. Lesions of the cardiac orifice of the stomach produced by vomiting. Journal of the American Medical Association; 1932, 98: 1353-1355

Ep-PAINE-nym



Boerhaave’s Syndrome

Other Known Aliasesnone

Definitionesophageal rupture from forceful vomiting

Clinical Significance This rupture occurs as a result of sudden increased intraesophageal pressure with negative intrathoracic pressure and the associated tear is most commonly located on the left posterolateral aspect of the distal esophagus. Gastric contents then invade the mediastinum and cause mediastinitis, necrosis, and severe bacterial infection that can lead to significant mortality.

HistoryNamed after Herman Boerhaave (1668-1738), who was a Dutch physician and earned his medical doctorate from the University of Harderwijk in 1693. He went on to earn a professorship at the University of Leiden in 1701, speaking on medicine, anatomy, botany, chemistry, and philosophy. It was during his time here that his repuatation as a skilled orator and teacher made international waves and physicians from all over the world came to listen and learn. He first described his eponymous disease in 1724 after witnessing the death of Baron Jan van Wassenaer after a retching following a particularly gluttonous feast.


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. Boerhaave H. Atrocis, nec descripti prius, morbii historia: secundum medicae artis leges conscripta. Leiden, the Netherlands: Lugduni Batavorum Boutesteniana, 1724
  7. Underwood EA. Boerhaave after three hundred years. British medical journal. 1968; 4(5634):820-5. [pubmed]