Artificial Intelligence-Oriented Heart Surgery: A Complex Bioethical Concept.

Artificial intelligence (AI) has come to the frontline, paving the way toward a future of operational efficiency. Following the current, cardiac surgery has evolved as well. We live in a world where AI has brought immense progress in almost every aspect of the field, but still, the question remains; will there be a time when robots will replace cardiac surgeons? The currently used operating systems necessitate constant supervision. Upgrading the algorithms from visual augmentation and post-operative prognosis to completely operating software is not something to be taken lightly. However, if we manage to succeed, would you be receptive to a fully autonomous robot as your surgeon? Significant barriers concerning bioethics emerge; the potential for misuse, risk assessment, supervision, referrals, the need to respect and protect patient autonomy and transparency while using the algorithms, and above all the understanding of the dynamics of illness and the human condition. So, can we provide a simple response to such a prime issue? The truth is, we cannot provide an answer for the future where an answer cannot be delivered effortlessly.

Alexander the Great (356-323 BC) and His Injury in Kyropolis Reconsidered.

Purpose: To reconsider Alexander the Great's injury in Kyropolis. Methods: Historical sources were compared with modern neurosurgery. Results: Earlier interpretations were focused on the transient blindness Alexander the Great presented after the injury, but according to our point of view we should rather focus on his dysarthria which lasted almost two months. Conclusion: We propose the hypothesis that Alexander the Great developed a posttraumatic delayed cerebellar syndrome after the injury.

Vieussens' Arterial Ring: Historical Background, Medical Review and Novel Anatomical Classification.

In coronary artery disease, the presence of Vieussens' arterial ring (VAR), a ring-shaped anastomosis between the conus branch of the right coronary artery with the left anterior descending artery (LAD), will allow blood flow to return to the obstructed coronary system. We have conducted a literature review, aiming to collect all the existing information about the documented VAR cases and any related pathological conditions. A total of 54 studies entered the review, including 56 patients. The mean age of the patients was 56.12 ± 16.2 years. Angina was present in 53.6% of the patients, with 7.2% of the cases being asymptomatic. Coronary artery disease outweighed (58.9%) as the patients' most frequent diagnosis. We propose a novel VAR anatomical classification, based on the sites of origin and termination of its course, with six distinct types, for a better understanding and surgical management of VAR. Type IA, originating from the conus branch and terminating in the proximal segment of the LAD was most frequently reported (51.8%). The recognition and the subsequent evaluation of the ring's anatomy and course are crucial for a customized clinical intervention. When right and left coronary angiographies fail to reveal any collateral circulation, selective conus artery catheterization should be in order. The proposed classification offers a manageable and comprehensive context for the assessment, evaluation and planning of therapeutic strategies of VAR and sets a new terminology frame for treatment guidelines.

Chemical Warfare in Ancient Greek Ionia: Mass Intoxication With Hecate's Deleterium.

The rich land of Erythrae in the coast of Asia Minor attracted the attention of the Ionian king Codrus. An oracle demanded the presence of the murky deity Hecate for him to conquer the city. Priestess Chrysame was sent by Thessalians to set the strategy of the clash. The young sorceress poisoned a sacred bull who turned mad, later to be released toward the camp of Erythraeans. The beast was captured and sacrificed. In the feast that followed, all ate a piece of his flesh and went crazy, stimulated by the poison, an easy prey for the army of Codrus. The deleterium used by Chrysame is unknown, but her strategy shaped the origin of biowarfare.

Medicinal plants in the treatment of urinary tract malignancies during the Araboislamic period (7th- 14th century AD).

Arabic medicine, or Arab-Islamic, mainly refers to all developments achieved in the Age of Khalifs, or the Golden Age of the Arab-Islamic civilization (ca 7th-14th centuries AD). Arab scholars adopted ancient Greek medicine and soon understood the essence of the fatal disease known as cancer. They introduced various new types of cancer, distinguishing other entities like infection and proposed new methods of treatment, both surgical and non-invasive. Herbal medicine after Dioscurides and Galen bloomed in the Arabic world. Malignancy of the urinary tract was identified and a plethora of herbs were used to slow down its expansion. Moreover, herbal drugs were introduced to alleviate cancerous symptomatology. Avicenna introduced Hindiba, while known scholars like Abulcasis and Rhazes noted the benefits of garlic, onion, black seeds, pomegranate, olive oil as well as leaf and bread wheat. Arabian herbal medicine may still be beneficial in anticancer fight and mainly in the palliative medicine. It should be emphasized that almost 50% of the drugs administered today have their point of origin in the plants used in antiquity.

Coexistence of Riedel's Lobe and Supernumerary Kidney as Random Imaging Findings.

Supernumerary kidney (SNK) is a rare congenital anatomical variation usually detected incidentally via imaging. Although a random finding, it may present with hydronephrosis, calculi or malignancy. Both its vascularization and its drainage vary significantly, depending on its location and shape. Riedel's lobe is a normal, though rare, variant of liver anatomy presenting either as a downward projection of the inferior border of the right liver lobe or as a triangular pyramidoid projection to the right of the gallbladder. We present a case of a 71-year-old man who was initially admitted to the hospital for backache. Computed tomography (CT) imaging revealed the simultaneous occurrence of a left supernumerary kidney and Riedel's lobe. The SNK lay caudally to the normal kidney, it was supplied by a branch of the superior mesenteric artery and its drainage was supported by a bifid ureter. The Riedel's lobe represented the "tongue-like" variant without causing any symptoms to the patient. Both entities should be monitored carefully, as their presence may require surgical management should they raise a sequence of symptoms or, as in this case, modify the surgical plans in the context of other coexisting medical events.

Hospital Agios Dimitrios: The General Public Hospital of Thessaloniki.

The purpose of this article is to highlight the history of Hospital Agios Dimitrios, the General Hospital of Thessaloniki. During the early 20th century, many refugees settled in the Greek city of Thessaloniki. To address the growing public health needs of the city's inhabitants, the Greek government established a health agency to offer medical care and respond to infectious disease outbreaks and epidemics. This initiative resulted in the construction or renovation of various hospitals. The Hospital Agios Dimitrios in Thessaloniki was completed in 1903. Its innovative architecture includes kiosks and wards designed to provide better ventilation and prevent the transmission of infectious diseases.

Covid-19 pandemic and bats: a lucky symbol of evil fortune.

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The ancient Greek roots of the term Toxic.

In ancient Greek literature the adjective toxic (Greek: τoξικόν) derives from the noun τόξo, that is the arc. This noun according to the Liddell - Scott - Jones lexicon had several meanings. Apart from the meaning that someone is able to use a bow or the military department of the archers, the medical context of the term is that a substance has the characteristic of a poison. This concept of the term survived until today with little differentiation.

John Watson (1807-1863) and his Pioneer Work On the Surgery of Esophagus.

Backround. John Watson (1807-1863) was the first surgeon in USA who performed and published his results on esophagotomy. Methods. His pioneer surgical work was a gold standard reference for the later surgeons. Results. Watson was a devoted surgeon and his innovative operating techniques secured him a place in the hall of fame of the history of medicine.

Theophrastus Bombastus Von Hohenheim (Paracelsus) (1493-1541): The eminent physician and pioneer of toxicology.

Theophrastus Bombastus Von Hohenheim known as Paracelsus was a German-Swiss homo universalis, or Renaissance man, whose interests included medicine, chemistry and toxicology. Characterized as a rebellious and great reformer of established medicine of his era, Paracelsus preferred observing nature, over studying ancient texts to find appropriate treatments for various diseases. He also used unconventional curative methods, such as minerals and other inorganic substances, which caused much controversy among his contemporaries. The main purpose of this article is to highlight his contribution on toxicology and the use of mercury.

The Greek physician and politician Ioannis Kapodistrias (1776-1831) and the plague of 1828 in Greece.

Count Ioannis Antonios Kapodistrias was an important political figure of the 19th century. He was a pioneer in the fight against epidemics and used his medical experience in Italy to protect Greeks from the 1828 plague. As a renowned diplomat and leader, Kapodistrias helped forge the federal state structure of Switzerland and formed the first organized administrative state in the Hellenic peninsula.

An innovative hippocratic cranial intervention for amaurosis in classical Greece.

BACKGROUND: Amaurosis is the sudden and acute loss of sight. Followers of Hippocrates in ancient Greece described amaurosis as a symptom of several ophthalmological pathologies, such as tumours or trauma. To treat it, surgery often was performed. METHODS: The Corpus Hippocraticum, edited by Littré, was thoroughly studied. RESULTS: The Corpus Hippocraticum describes the surgical treatment for amaurosis, which involves drilling with specialized tools (i.e. trephines) into the affected area of the temporal bone. It was believed that this procedure would help release demonic spirits and balance the bodily humours. Physiology of the era assumed that fluids in the head sometimes exerted high pressure on the optical nerve and that this fluid needed to be alleviated. CONCLUSIONS: Ancient Greeks studied cranial anatomy and understood the main principals of internal bleeding and inflammation. They treated some of the neurological symptoms that resulted from these conditions with surgery.

Gottlieb Burckhardt (1836-1907): 19th-Century Pioneer of Psychosurgery.

Gottlieb Burckhardt was a 19th-century Swiss psychiatrist who introduced the psychosurgical method known as topectomy as a means to relieve the symptoms of aggression and agitation in individuals diagnosed with mental disease. Specifically, he performed topical excision of part of the cerebral cortex on 6 patients with chronic schizophrenia. Most of these patients became more approachable and easier to manage, but they also showed signs of aphasia or seizures, and 2 died soon after the surgery. Burckhardt's presentation of the results of his surgical procedures to the Berlin Medical Congress in 1890 caused an enormous controversy within the European medical community and resulted in his ostracism from it. He continued practicing, however and dispensing advice in his role as a mental hospital director, though he soon gave up his surgical endeavours. His innovative theory of higher cerebral functions anticipated the lobotomy procedure that was developed nearly half a century later by the neurologist Egas Moniz (1874-1955).

Morphometry of the Brachiocephalic Artery: A Cadaveric Anatomical Study.

Introduction The brachiocephalic artery (BCA) is the largest branch that arises from the aortic arch, which varies in length. The present study focuses on BCA length and its probable correlation with height and torso length. Methods The BCA length (from the artery's origin to the arcus aortae), the length of the torso, and height were measured in 76 embalmed adult human cadavers of Caucasian (Hellenic) origin. Results A total of 74 arteries were measured (36 females and 38 males). The mean length was found to be 3.82 cm (SD=±0.947, SE=0.110). In male cadavers, the mean BCA length was 3.94 cm (SD=±0.980, SE=0.159) and in females, it was found to be 3.69 cm (SD=±0.905, SE=0.151). No statistically significant difference was found (p=0.248, p>0.05) The mean torso length was 62.27 cm (SD=±4.325, SE=0.496) and the mean height was 155.3 cm (SD=±10.124, SE=1.161). The BCA length was correlated with body height and torso length in both sexes. A statistically significant correlation was found only between BCA length and body height in male cadavers (r=0.267, p=0.021). Conclusion The morphometric characteristics of the BCA are of great importance in a number of surgical procedures, such as stenting and catheterization in cases of aneurysms. One statistically significant correlation was observed in our study, which could be considered an important finding, as it could lead to the plausible assumption that greater height leads to the formation of larger arteries.

William Cheselden (1688-1752): 18th-Century Pioneer of Lateral Lithotomy and Iridectomy.

William Cheselden (1688-1752) was a British surgeon and anatomist who was famous for his rapid and skilful techniques. He emphasized learning through dissection and introduced lateral lithotomy as an effective approach for the removal of bladder stones. Medical practitioners throughout Europe adopted his techniques. Cheselden also has been credited with the first known case of full recovery from blindness using iridectomy. Moreover, a milestone in his career was his indirect instigation for the separation of surgeons from barbers. He is considered the founder of modern British surgery.

Paul of Aegina (ca 625-690 ad): Byzantine Surgeon and Pioneer of Surgical Management of Congenital Atresia of the External Auditory Canal.

Diseases of the ear have been recorded and treated since ancient times. Ex-votos have been offered to heal deafness. Noninvasive treatments have evolved into minor, and later more advanced, surgical techniques to treat head and neck issues. Paul of Aegina (ca 625-690 ad) perfected his medical skills in the School of Alexandria in Egypt. His medical encyclopedia, Medical Compendium, described a broad series of surgical operations, including a chapter "On the atresia of the auditory canal," which vividly described a surgical technique to open the ear canal. This surgery is particularly interesting, as it exceeds the limits of resection and amputation known at that time and describes a novel surgical technique. His innovative methods paved the way for future surgeons.