Rediscovery of Otto Frank's contribution to science.

In the late 19th century, German physiologist Otto Frank (1865-1944) embarked on a near life-long research program of laying down the mathematical, methodological, and theoretical foundations in order to understand and define the performance of the heart and circulatory system in all their complexity. The existence of the "Frank-Starling law" testifies to this. Two of his seminal publications have been translated into English previously, introducing Frank's research on the dynamics of the heart and the arterial pulse to a wider audience. It is likely that there are a host of other comparable achievements and publications of Frank that are still unknown to the international scientific (cardiological and physiological) community. However, their influence can still be felt and seen in modern cardiology and cardio-physiology, such as in the development of modern interactive simulating and teaching programs. We have translated and commented on ten of these papers, which can be read in parallel with the German originals. These publications show a wealth of theoretical assumptions and projections regarding the importance of the sarcomere, the development of models of contraction, thermo-dynamical considerations for muscular activity, differences between cardiac and skeletal muscles, problems related to methodology and measurement, and the first pressure-volume diagram (published 120 years ago). These topics were envisioned by Frank long before they became a focus of subsequent modern research. Nowadays, frequent measurements of pressure-volume relationships are made in research using the pressure-volume conductance catheter technique. In commenting Frank's scientific topics, we try to show how interconnected his thinking was, and thus how it enabled him to cover such a wide range of subjects.

Carl Ludwig's (1847) and Pavel Petrovich Einbrodt's (1860) physiological research and its implications for modern cardiovascular science: translator's notes relating to the English translation of two seminal papers.

Respiratory interactions with the heart have remained a challenging physiological phenomenon since their discovery more than two hundred and fifty years ago. In the course of translating the seminal publications of Carl Ludwig and his disciple Pavel Petrovich Einbrodt into English, we became aware of some under-appreciated aspects of their work that contain useful insights into the history of the phenomenon now called respiratory arrhythmia. Ludwig observed arrhythmic effects of respiratory movements in experiments on dogs and horses and published his findings in 1847. He subsequently undertook further work on this problem, together with Einbrodt. Already in 1847 Ludwig had mentioned an exciting observation on the possible role of mechanical factors of the respiratory movements on the action of the heart in a dog in whom he had artificially induced bouts of coughing. Einbrodt decided to systematically develop methods to increase or decrease the pressure of the air the animal had to breathe. He observed that this procedure led to a greater or lesser degree of compression or decompression of all the organs in the thoracic cavity without apparently causing harmful consequences during the time of its application. How the mechanical influence of breathing affects cardiac activity during respiratory arrhythmia has been the subject of scientific discussions and controversies over a period of more than 150 years and is still unresolved. Recent publications suggest that cardiac mechano-electrical coupling plays an important role in the emergence of cardio-respiratory interdependence.

[The category gender and meeting standards for medical education as a result]. / Die Kategorie Geschlecht und die daraus resultierenden Anforderungen an die medizinische Ausbildung.

The Medical School Hanover, Institute of History, Ethics and Philosophy in Medicine, in co-operation with the University of Bristol, School for Policy Studies, carried out a project to examine the meaning of gender in medical education and to detect methods to incorporate the gender-perspective from public health research and gender studies as an interdisciplinary programme into medical education. The duration of the project was limited to two years, and funded by the EU from 2001 to 2003. The study clearly shows that the category gender is being very slowly introduced into medical education at medical faculties and medical universities in Europe. Questions are primary focussed on biological differences between the sexes of patients, whereas gender studies touch gender relationships in occupations, interactions and communication, different styles of leadership etc. The adaptation of this approach may lead to a new understanding of the doctor-patient-interaction as well as of the relationship between teachers and students.

Domestic violence--a comparison of activities in the health care sector in Brazil and Germany.

During the last decades an, international discussion has started on how to reduce the gender gap in women's and men's health. Feminist activists and public health scientists in Canada, Latin America (foremost Brazil), the States and South Africa issued a declaration of intention to focus on health impacts caused by gender-related domestic violence. In Europe, and particularly in Germany, the topic as an issue of medical care has lately been given increased attention. In this article, we present activities undertaken to overcome the obstacles in integrating the topic of domestic violence as a medical issue. The successful Brazilian strategy served as a model, in particular for implementing a hot-line for victims of domestic violence within the day-to-day clinical setting. The General Medical Council (Arztekammer), the Women's Medical Association of Lower-Saxony, and the Hanover Medical School founded a working committee "domestic violence" in co-operation with the Ministry of Women, Work and Social Affairs. Between 2002 and 2003, this task force worked out several guidelines and hand-outs for physicians to promote gender-sensitive treatment of abused women, gaining increasing acceptance by the German medical care providers in medical education and in-training services for physicians.