[The practice of BCG vaccination in 1930 s' China].

Wang Liang introduced Bacille-Calmatte-Guerin(BCG) to China in 1933 in order to prevent tuberculosis. He established a BCG laboratory and make BCG strains by himself in Chongqing, and vaccinated children around, until he was forced to stop doing it by the government in November, 1937. In 1938 Shanghai Pasteur Institute was established, and they built a BCG laboratory to promote BCG vaccination in Shanghai, and these actions were insisted during 1940s. But in 1930s the medical profession all over the world was skeptical to BCG efficacy, which impeded the promotion of BCG vaccination in China. Without the collaboration of the government and the national medical profession, tuberculosis problem in China couldn't be improved by the effort of single doctor or an institute.

[Tuberculosis vaccines]. / Vaksiner mot tuberkulose.

Even though the BCG vaccine is one of the most used vaccines in the world, tuberculosis is still a major problem worldwide. Research aimed at developing new vaccines against tuberculosis has become more goal-directed during the last 10-15 years, and there are now several vaccine candidates in clinical study phases I and II, that should be in phase III in 2010. It will then still take several years before we know whether a new vaccine will reduce the occurrence of tuberculosis. There are several promising vaccine candidates, but there is uncertainty whether they will be successful in reducing tuberculosis, as we do not have sufficient knowledge about protective immunity in tuberculosis. Today's vaccine candidates have been developed to protect against a few laboratory strains of the bacteria and will not protect against all strains. Estimations show that an effective vaccine against latent tuberculosis will give a rapid and considerable reduction in tuberculosis. The current vaccine candidates are however developed to protect against primary tuberculosis and not against reactivated latent tuberculosis. It is important to ensure an optimal experimental basis for new tuberculosis vaccines and to compare them so the best can be selected.

The 'experimental stable' of the BCG vaccine: safety, efficacy, proof, and standards, 1921-1933.

The anti-tuberculosis BCG (Bacille Calmette-Guérin) vaccine was conceived and developed between 1905 and 1921 at Pasteur Institutes in France. Between 1921 and A. Calmette's death in 1933, the vaccine went through a first period of national and international production and distribution for its use in humans. In France these activities were exclusively carried out by Calmette and his collaborators at the Pasteur Institute in Paris. Initially improvised production in a small room in the cellar gave way in 1931 to the construction of the spacious and magnificent 'New laboratories for research on tuberculosis and the preparation of the BCG' within the premises of the Pasteur Institute. Presentation and image-building of the vaccine in France insisted on the fact that the BCG was not a commercial specialty but distributed free of charge. The technical monopoly of its production nevertheless lay with the Paris Pasteur Institute and standardization of scientific proof of safety, efficacy and stability was dominated by that Institute in France. In contrast, the international production and distribution of the vaccine was entrusted and transferred, free of charge, to trustworthy laboratories outside France. Multiplication of producers and users led to an increased need for standardization. For this process the analysis distinguishes between the standardization of scientific proof concerning safety, efficacy and stability of the vaccine and standardization of its medical uses. Whereas standardization was rather successful in the inter-war period in France, the international efforts remained rather unsuccessful. Only after world war II under Scandinavian leadership and in the context of mass vaccination programs supported by the WHO and UNICEF was the international standardization effectively implemented and succeeded at least to some extend.

Third chapter of surgeons lecture: revolution in urology and its evolution in Singapore.

Urology has been an evolving specialty since the time of Hippocrates. The itinerant surgeon was known to go from town to town to remove bladder stones in the early middle ages. In this century, urologists had been at the forefront in pioneering minimally invasive surgery with the introduction of transurethral resection of the prostate more than 50 years ago in the United States. This could be considered the first revolution in urology and this has influenced the evolution of urology in Singapore. Transurethral surgery had proved to be far superior to open surgery for most lesions of the lower urinary tract. This technique was introduced to Singapore in the early 1970s by Dr N E Wong. Because of the need for special instruments, skill and training, there was a need for a Department of Urology. This was not to be until after the second revolution in urology. The second revolution saw the introduction of endoscopic surgery of the upper urinary tract and Extra-corporeal Shockwave Lithotripsy in the early 1980s. This had truly revolutionised the treatment of urinary stones and today almost 95% of patients can be treated with these non to minimally invasive techniques. These new modalities of treatment were rapidly introduced in Singapore in the mid 1980s. The need for the establishment of urology as a specialty was more urgently felt. The Singapore Urological Association was formed in February 1986 and in March 1987, a Division of Urology was formed at the Singapore General Hospital.(ABSTRACT TRUNCATED AT 250 WORDS)

Hypothesis of leprosy, tuberculosis and urbanization in Africa.

Leprosy today is a problem of global magnitude affecting possibly up to 15 million people. Its rise and fall in medieval Europe is an historically fascinating enigma. Partial cross-immunization by epidemic tuberculosis, reinforced by the growth of cities, has been proposed as a mechanism in leprosy's European disappearance, but evidence is lacking. In the case of Africa in recent decades, analysis of leprosy and tuberculosis rates, and of levels of urbanization, albeit with imperfect data, suggests a possible environmental health for leprosy, the existence of some cross-interference between tuberculosis and the milder, paucibacillary form of leprosy, and a negative correlation between leprosy and urbanization. It is argued that the rise of the city in Africa, acting through a combination of influences, including tuberculosis, is leading to a decline of leprosy.

Vacinaçäo BCG por via oral no Brasil / Oral BCG vaccination in Brazil

Histórico sobre a introduçäo da vacinaçäo contra a tuberculose no Brasil. Afirma que a vacina BCG foi iniciada no Brasil pelo Dr. Arlindo de Assis em 1926, em Niterói. Descreve os métodos de vacinaçäo no exterior e as campanhas de combate à tuberculose no Brasil.(JGC)