ABSTRACTS SESSION #3

’Let there be light’ – and there was light
– Fri 24 May, 11:30 – 13:00

#1 Presenter: Poul Jørgen Jennum, Professor, DMSc, Chief physician
Danish Center for Sleep Medicine, Rigshospitalet, Copenhagen

History of daylight, health and the circadian rhythm
The earliest identification of circadian processes dates back to the 4th century. The first record of endogenous circadian oscillator was noted by the French scientist Jean-Jacques deOrtous de Mairan in 1729, when he discovered a 24-hour patterns in the plant Mimosa pudica.

Identification of the 24h cyclicity was noted in 1896 and primarily in 1900 a 24-hour activity pattern in the absence of external cues such as light and changes in temperature was identified. Ron Konopka and Seymour Benzer identified the first clock mutant in Drosophila in 1971 and called it ‘period‘ (per) gene, the first discovered genetic determinant of behavioral rhythmicity.

The per gene was isolated in 1984 by two teams of researchers. Konopka, Jeffrey Hall, Michael Roshbash and their team showed that per locus is the centre of the circadian rhythm, and that loss of per stops circadian activity. Further discoveries lead Hall, Rosbash and Young to receive the Nobel Prize in Physiology or Medicine 2017. 

The circadian cyclicity is maintained by entrainment on light. Discovery of the two-process model of sleep integrating sleep-wake rhythmicity (homeostatic process) and the circadian process was described by Alexander Borbely in 1982.

Understanding of the regulatory pattern have since lead to understanding for relation to health, poor health, several disease processes. Understanding of these mechanisms have major implication of areas as different as memory consolidation, consciousness and metabolic processes.

#2 Presenter: Benny Vittrup, Chief Physician
Dep. Oncology, Herlev Hospital, Copenhagen

A Historical Light On The War Against Cancer: Can We Win This War?
Cancer is a distorted version of ourselves and has been perceived as the emperor of all maladies. As a threat towards human survival cancer has a profound impact on the thinking in philosophy, science, culture and politics. Cancer is the lens through which mankind get the clearest light on the limitations in our existence. 

Darwin’s observational evolution theories – later understood as adaptive oncogenic mutations – gradually pulled cancer into the light from the darkness of religion. In the mid 1800’s Virchow by help from the light microscope could demonstrate that all cells come from normal cells including cancer cells.

In the late 1800’s Paul Ehrlich could selectively color cells and microbes with chemicals. He formed the idea of “magic chemical bullet” that selectively could kill cancer cells.

In 1953 the 4-letter molecular language of nature (DNA, RNA and protein synthesis) was revealed forming the scientific basic for mankind’s war on cancer that was politically declared in 1971. The weapons were cell toxins originally discovered during world war I and radiation aiming at killing cancer cells by destroying their DNA, RNA and protein machinery.

With the discovery of the oncogenes new weapons was added aiming at killing mutated carcinogenic oncogenes. The discovery that our immune system daily destroys billions of carcinogenic oncogene mutations and protects us from cancer led to the aim of using the immune system as a weapon.

This lecture casts a historical light on the development of cancer therapy and a cautious optimism of winning this war.


Leprosy Revisited
– Fri 24 May, 11:30 – 13:00

#1 Presenter: Jesper Lier Boldsen, Professor MSO, PhD (lic.scient.), Dr.Med.Sci. (Dr.Med)
Unit of Anthropology (ADBOU), Dept. of Forensic Medicine, University of Southern Denmark.
Curriculum Vitae for Jesper Lier Boldsen
JBoldsen@health.SDU.DK

Leprosy: T
he Menace of the Medieval Period
The diagnosis of leprosy based on ancient skeletons is a probability statement as are all diagnoses. A lot of diagnostic tests with high sensitivities and specificities are available for modern diagnostic medicine. This is not the case n paleopathology.

In the case of leprosy it has been necessary to estimate sensitivity and specificity of six different leprosy related lesions by optimizing a 15-dimensional likelihood function. Using these statistics it has been possible to estimate the frequency of leprosy at death in several samples of skeletons. The statistical methodology developed is better suited to estimate sample frequency than to classify individual skeletons as those from people who did or did not suffer from leprosy.

Several historical and medically interesting conclusions have come out of this research. First of all, leprosy was a very common disease that affected a large but variable fraction of the adult population. The frequency of leprosy was, of course, higher among those buried on leprosarium cemeteries; but on ordinary medieval cemeteries between 4 and 47 % of the adults buried there suffered from leprosy at the time of death.

Leprosy is generally an adult onset disease. Based on Norwegian leprosy data from 1850-1920 it has been possible to describe the transition profile from the healthy to the leprous stage in a pre-antibiotic population. Using this profile it has been estimated that the relative risk of dying for people suffering from leprosy was two time as high as for people who did not have leprosy. Following this it appears that in the village community of Tirup (Eastern Jutland, AD 1150-1350) leprosy reduced the productivity of the population by 10%.

The leprosaria (Sct. Jørgensgård) were established in Denmark from the 13th to the 17th century. In Odense it appears that the founding of Sct. Jørgensgård in the 1270s lead to the eradication of leprosy within 75 years – around 1350. In rural communities leprosy prevailed to shortly after the end of the Medieval Period in the middle of the 16th century.

#2 Presenter: Magnus Vollset, PhD
Department of Global Public Health and Primary Care, University of Bergen, Norway.
Magnus.Vollset@uib.no

Leprosy in Scandinavia: Institutions and legislations, 1840-1940
After Danielssen and Boeck’s celebrated monograph “Om Spedalskhed” (1847/48), the Norwegian state established a research hospital tasked with developing a cure, as well as three large institutions to serve as “good homes” for people affected by the disease. In Iceland, the same publication led to the leprosy hospitals being closed: Now that the disease was decidedly hereditary, segregation in run-down institutions was seen as unnecessary cruelty. Fifty years later, however, research proving an increased prevalence, the rise of contagionism, and money from the Danish branch of Odd Fellows, meant both new leprosy legislation and the opening of a new leprosy hospital.

In Sweden, a ‘leper asylum’ with twenty beds opened at Järvsö in 1870, and was soon expanded. In Finland, a state leprosy institution opened near Helsinki in 1900. Barely a decade later, at the Second International Leprosy Congress in Bergen in 1909, Germany, Iceland, Norway and Sweden were hailed as the exemplary in their isolation of ‘lepers’.

This paper will give an overview of leprosy institutions and legislations in Scandinavia, 1840-1940, based on published reports and discussion from the period. It will discuss differences and similarities between the Scandinavian approaches, as well as how they influenced one another.