Highlights of a Career in Medical Science

Copyright © 1980 Ohio Acad. Sci. 0030-0950/80/0005-0195 $2.00/0

HIGHLIGHTS OF A CAREER IN MEDICAL SCIENCE1- 2

LIBERATO JOHN A. DiDIO, Dean of Graduate School, Medical College of Ohio at Toledo,Caller Service 10008, Toledo, OH 43699

OHIO J. SCI. 80(5): 195, 1980

In thinking about this presentation, Idecided to share with you the highlightsof my career as a scientist, which on thisceremonious occasion may be consideredthe confessions of an Academy President,and to dedicate the presentation espe-cially to the young scientists of Ohio.I should alert you, however, that as aphysician who is concerned with pre-ventive medicine, I will not deliver apurely serious speech. Science is serious,but not necessarily sad—as you shallsee, I have thoroughly enjoyed my lifeas a scientist.

Trained as a surgeon, early in mycareer I made the decision to become an

Manuscript received 28 June 1980 and in re-vised form 8 July 1980 (#80-36).

PRESIDENTIAL ADDRESS—Presentedat the 89th Annual Meeting of the Ohio Acad-emy of Science held at The University of To-ledo, Toledo, OH on 20 April 1980. Dr.Liberato J. A. DiDio, Dean of the GraduateSchool and Chairman and Professor of Anatomyat the Medical College of Ohio, served as Presi-dent of The Ohio Academy of Science 1979-1980. He received his B.S., M.S., M.D. andPh.D. degrees, all summa cum laude, from theUniversity of Sao Paulo, Brazil. After 21years in academic medicine at Brazilian uni-versities, he became a research Fellow at NewYork City's Rockefeller University and latermoved to Northwestern University as Professorof Anatomy. He was appointed Chairman ofthe Department of Anatomy at the MedicalCollege of Ohio in 1966 and Dean of the Gradu-uate School in 1972. The University of Toledochapter of Phi Kappa Phi cited him as a dis-tinguished member and the International In-stitute of Greater Toledo presented him withthe Golden Key Award. Proficient in 5 lan-guages, Dr. DiDio has published well over onehundred scientific papers. His many inter-national honors include Honorary President ofthe Pan American Association of Anatomy, theOrder of Merit in Medicine of the Republic ofBrazil, the Andreas Vesalius Award from theMexican Society of Anatomists, the Medal forCultural Merit of the Republic of Italy, andthe Rorer Award from the American Society ofGastroenterology.

anatomist and to devote my life to dis-assembling, studying, and analyzing oneof Nature's masterpieces. My lifelonglearning has led me to an appreciation,highlighted by a continuing sense ofwonder, of the miracle of life and thehuman body. From the practical stand-point, my decision to be an anatomistwas to serve mankind through my workas a scientist and educator. I latercame to realize that I recreated in myown life the same situation that existedat the creation of the world. When itwas asserted that God must have been asurgeon, as only through surgery couldHe first perform the costectomy inAdam to create Eve, an anatomist pro-tested, saying that God first had to knowanatomy in order to find the proper rib.At that point, an educator intervened,exclaiming: Everyone knows that in thebeginning there was chaos and who knowsbetter than educators how to createchaos? So, while creating chaos, I havehad an opportunity to do some research,to teach, and ultimately to help my fel-low humans during our sojourn on thislovely planet.

I became a scientist because I felt thatI could reach many more human beingsif, instead of treating patients individ-ually, I could, as a result of my investi-gations, make a discovery that wouldbenefit untold numbers of people. Irecognized that in this respect I was onvery thin, idealistic, ground; but an in-nate optimism sustained my hope that Icould succeed. Early in life, I believedthat instead of looking at things and ask-ing why, one should aim for impossibledreams, asking why not? As psychi-atrists have attempted to explain suchillusions of grandeur, they state that itis normal to be an arsonist at age 18 anda fireman at 25. With the naivete and

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196 LIBERATO JOHN A. DiDIO Vol. 80

determination characteristic of youth, Ipromised myself that I would be the topstudent in my class, and would devotemyself to mastering everything that myinstructors taught. Knowing how ca-pricious grading systems and individualteacher's judgments can be, not to men-tion personal preferences and biases, itcan readily be seen that much juvenileboldness was involved in the goals I hadset for myself.

Another goal was to acquire broadknowledge of the medical sciences and,at the same time, to perform investiga-tions into different areas and levels ofstructure of the human body utilizing avariety of techniques, striving to be botheclectic in medical biology and profoundin each field at the vanguard of science.If successful, I would be able to grasp themeans of attack for each scientific prob-lem from different angles without losingthe general view of the main field and pos-sibly of adjacent fields as well. Ulti-mately, my aim was to acquire a deep in-sight into each problem while maintain-

ing a broad view of the subject. Whilesome of my colleagues were devotingtheir efforts to becoming experts in thesubspecialties of anatomy, as a youngDon Quixote, I tried to master all of them—an almost impossible dream.

The next problem was to select amentor who could serve as a paradigm inmy idealistic quest. I selected ProfessorRenato Locchi (1896-1978), who ulti-mately became my spiritual father.Under this inspiring teacher, physician,pharmacist, anatomist, and philosopher,I began to study the incidence of Whit-nall's orbital tubercle (DiDio 1942) inthe human zygomatic bone (fig. 1),which was rarely mentioned in anatomytextbooks. I wondered then whetherthe absence of description was due to thelack of confirmation in finding the promi-nence or due to the negligence of anato-mists toward the relatively recent dis-covery by Whitnall in 1911. Whilesearching the literature on the subject, Istudied 285 skulls and found, amongmany other data, that the prominence

FIGURE 1. Anterior view of a human male, adult skull showing the eminentia orbitalis (arrows)of the zygomatic bone in each orbit.

Ohio J. Sci. A CAREER IN MEDICAL SCIENCE 197

occurred in 89% of the cases—91% inmales and 82% in females. Surroundedby numerous skeletons in an enormousosteology museum, where the deep silencewas broken only by my pen as it com-mitted my observations to paper, I can-not describe the awe of that moment.Suffice it to say that what started as aseemingly macabre investigation, work-ing in solitude among a multitude ofhuman skulls, became an exciting ex-perience. Those lifeless skulls were trans-formed through intense and devotedstudy from objective research materialto sensible, although inert, individuals.They became my new, quiet, docilefriends, and I became their admirer.By the time the investigation was com-pleted, I had developed from a naive,idealistic student into an embryonicscientist who had found life in death, forthrough those dead skulls I had foundmy life as a scientist. The same friend-ship later developed with 100 patientswho volunteered to participate in a studyto observe and detect the orbital emi-nence in vivo. I came to know each ofthem by name and I am still grateful toeach and every one.

In the realm of science, the study notedabove confirmed that the bony projectionwas found in almost all cases and demon-strated it with x-rays for the first timein living individuals. The morphologystudies justified a change in its name toeminentia orbitalis. My paper receivedrecognition when Terry and Trotter(1953) quoted it in their chapter onosteology in Morris' Human Anatomy.

Twenty years later I repeated thisstudy in a unique series of skulls fromIndia in the Department of Anatomy atthe University of Washington School ofMedicine. The results confirmed thatthe orbital eminence is present in 96%of the cases (DiDio 1962).

I was reminded of the contribution ofanother young student, Ruggero Oddi,who in 1887 discovered the sphincter atthe termination of the bile duct in theduodenum. Although my statistical studycannot be compared to Oddi's discoverywhile he was a student, I do wish to em-phasize that young investigators shouldbe proud to know that the name of astudent was given to an anatomical

structure—Oddi's sphincter—and even toone of its diseases—Odditis. It has be-come one of the most widespread eponymsin the world's medical literature. As aninvestigator studying the orbit, I felt thatI had already become a doctor of phi-losophy in the eminentia orbitalis—aminuscule prominence on the skull, but agigantic structure for a neophyte medicalstudent and incipient young anatomist.Life would later teach that dimensionsshrink in relation to the scientist's age—another aspect of one's relativity.

In retrospect, the eminentia orbitalisproject was the first highlight of a sci-entific career and a honeymoon withscience that is still going on. In fact,while perusing an issue of the FoliaAnatomica Japonica, in which I wassearching for an article on the orbitaleminence, I happened to open to page105—a lucky accident—where I found amost unusual paper by Okamoto (1922)describing a narrowing of the left commoniliac vein. I will refer to this researchproject later, as it eventually became mythesis topic for the doctor of sciencedegree.

Having decided to begin work in thechemistry laboratory of the physiologydepartment, I had to give up promisingcareers in baseball, basketball, fencing,and soccer, forgetting about "mens sanain cor pore sano . . . " This new activitywould familiarize me with and, if possible,lead me to master the basic techniquescommonly utilized in experimental re-search at the molecular level of biologicalstructure. Following the directions ofmy advisors in physiology, I studied theimportance of traces of manganese innutrition and in human biology from thebiochemical and functional standpoints(DiDio 1943 and 1944). The projectoriginated from Orent and McCollum's(1931) interesting observation that amanganese-free diet prevented rats fromnursing their young in 58 out of 59pregnant animals. Knowing that anincreasing number of women were notable to secrete sufficient milk to breast-feed their infants, I raised the questionof whether the absence in foods of man-ganese, one of the oligodynamic elementsthat acts as a catalyst, might be respon-sible for the deficiency. An interesting


study performed in the city of Sao Pauloindicated that while most of the wealthywomen could not provide milk to nursetheir infants, most poor women hadabundant milk to feed usually numerousinfants as well as to nurse the infants ofothers. Perhaps the poorer people, eat-ing the less expensive, unpolished grains,ate some of the seed coat (or cuticle)through which needed minute amounts ofmanganese were obtained. To make along story short, it was determined thatmanganese is found in the lupine seedand is more concentrated in the cuticleof rice, soybeans, black beans, corn,mango, and lupine seeds than in thepulp. With modern food processing andelaborate cooking, it was likely that thesetraces of manganese—so essential fornutrition—were lost. The paper waspublished and was widely quoted, but itmarked the end of my scientific activitiesin the field of physiology.

As World War II raged, I was trainedto become an infantry officer while goingthrough medical school. Lack of timeand my curiosity about the unusual nar-rowing of the left common iliac veinmade me give up the continuation of thework on manganese and to concentrateon research in anatomy. The first au-thor to describe adhesions that reducedthe lumen of the common iliac veins wasMcMurrich (1906, 1907, 1908), who dis-covered adhesions in the venous wallswhile searching for valves in the veins.He attributed the adhesions to the pres-sure exerted by the right common iliacartery and to defective embryological de-velopment. Having observed a muchhigher incidence of adhesions in the leftthan in the right iliac vein, McMurrichcorrelated the finding with the most fre-quent cases of thrombosis in the left in-ferior member. Several authors investi-gated this question, but, with few ex-ceptions, the literature on the subjectwas enlarged but not enriched.

The confusion that then existed chal-lenged further study on the problem. Itturned out that the adhesions had a rela-tively high incidence (approximately40%), predominantly in the left commoniliac vein, and were not congenital butacquired formations caused by the ar-terial compression and pounding of the

vein (DiDio 1949) against the vertebralcolumn (figs. 2, 3). The adhesions were

FIGURE 2. Diagram of the common iliacveins and the beginning of the inferior venacava and their anterior relationship withthe aorta and the common iliac arteries(female, adult, Caucasian). The cross-hatches indicate an adhesion between theanterior and posterior walls of the ter-minal segment of the left common iliacvein, corresponding to the area relatedto the right common iliac artery. InsetA shows a cross section of the posteriorwall of the right common iliac artery infront (v) of the obliterated left commoniliac vein (d) at the level of the arrow A(from DiDio 1949).

unrelated to developmental inhibition,and their location in the left vein pro-jected posteriorly on the most prominentportion of the anterior aspect of the discbetween the 4th and 5th lumbar verte-brae. This coincidence suggested thatthe upright posture of man was, at leastin part, responsible for the occurrence ofadhesions as well as for the appearanceof varicose veins, a disease found only inhumans. The posterior aspect of theterminal segment of the left common iliacvein was actually pinched by an arterialforceps, formed by the right commoniliac artery (anterior to the vein) and themiddle sacral artery (posterior to thevein), at the level of the above men-tioned intervertebral disc. This rinding—a vein squeezed between arteries—•caused a chain reaction, as is common inscientific research, leading me to extendthe study to the renal vein (DiDio 1956),which is also under the same stress. Onecan imagine the thin walls of a vein suf-fering the continuous hammering of twoarteries at the average rate of 72 beats

Ohio J. Sci A CAREER IN MEDICAL SCIENCE I'M)

per minute throughout an entire lifetime.Ultimately, in the case of the left com-mon iliac vein, this beating caused ad-hesion of its walls, leading to a reductionof the lumen and manifesting itself asunilateral varicose veins, edema, andthombosis. For example, the appear-ance of temporary edema is common atthe beginning of pregnancy in the leftinferior member or, when bilateral, ismore pronounced on the left side. Thisis caused by an enlarged uterus that in-creases the arterial compression againstthe vein. The completed work was pre-

ject to me for continued investigation.I accepted his gift with pride and fear:pride because he safeguarded his favoriteproject by placing it in my hands andfear because I might not live up to hisexpectations. The bibliography on thesubject was enormous, and the studyculminated in the presentation of myPh.D. dissertation in anatomy (DiDio1952), which was approved summa cumlaude. The results of the investigationrevolutionized the historical, anatomical,histological, physiological, radiological,clinical, and surgical aspects of the ter-

FIGURE 3. Cross section of the left common iliac vein at the level of an adhesion(male, adult, Caucasian), a = adhesion between the anterior and posterior venouswalls; b and c = medial and lateral extremities of the adhesion, respectively.Weigert-Van Gieson staining. X8.3 (from DiDio 1949).

sented as my thesis for the doctor ofscience degree, and it was unanimouslyapproved summa cum laude. The thesisreceived significant recognition 8 yearslater when Peck (1957) used my find-ings to explain the clinical signs of vas-cular insufficiency and subsequent slowergrowth of the affected inferior member.The venous obstruction and stasis causedgrowth insufficiency by slowing circula-tion and consequent oxygen deprivationto the tissues. Peck concluded that theassociation in many of dependent cyano-sis or mottling, shortening of the bonesof a member, and a decrease in circum-ference of the extremity, may represent aclinical syndrome, possibly related to aniliac venous obstruction, causing a par-tial block of the venous blood drainage.

My advisor, Professor Locchi, wassearching in 1943 for references to theso-called "Bauhin's ileocecal valve" (atthat time the luxury of a computerizedlibrary was not available) and pressed byadministrative duties, presented the pro-

minal ileum. I was even able to make acinematographic film of the opening ofthe ileum into the large intestine in aliving patient with a cecostomy—a pro-ject that had been unsuccessfully at-tempted by others. This work wasselected by the organizing committee ofthe International Congress of Anatomyin Paris (1955) to be presented at theopening plenary session and is one of veryfew cases (40 in the world literature) ofdirect in vivo observation recorded, il-lustrated, and published. My eleventhcase of in vivo observation of the terminalileum was published in collaborationwith Rosenberg (1969) and received theW. H. Rorer Award in Gastroenterology.

Our bibliographical data, the investi-gations in cadavers and in the living in-dividuals, furnished several interestingdata, some of which put me in the posi-tion of an iconoclast. For example,from the anatomical, historical, andterminological standpoints, the "ileocecalvalve of Bauhin" is not ileocecal, is not avalve, and is not Bauhin's! I was


shocked to read Sappey's (1879) state-ments about Bauhin's plagiarism: "Theileocecal valve was discovered in 1573 byC. Varolius, who in pointing out itsexistence, also very clearly defined itsfunctions. He gave it the name ofoperculum of the ileum. . . . By super-imposing the two texts, their identitybecomes evident. In order to concealthis somewhat, Bauhin took care to inter-polate in his paragraphs an incidentalphrase. . . . This author, then, is guiltyof an act of scientific piracy which his-tory, in its impartial and inflexiblerigour, would hardly know how tostigmatize enough" (DiDio 1952, DiDioand Anderson 1968). I learned, for thefirst time, that even in science, in thesearch for truth, where honesty at anyprice is the basic ingredient, there maybe corruption.

The next problem was to find a propername for the "valve that was not."Based on the morphological, microscopic,functional, and radiological aspects, Iproposed the name ileo-ceco-colic papilla,containing a biological device, the ileo-ceco-colic pylorus, to open and to closethe orifice between the small and large in-testine. Because the adjective form wastoo long, the present proposed names areileal papilla for the structure and ilealpylorus for the muscular device (con-taining two components, a circular sphinc-ter muscle and a longitudinal dilator mus-cle) similar to the gastroduodenal pylorus(%• 4).

A remarkable fact was the major dif-ference between the morphology of theterminal ileum in the cadaver and in theliving individual. Post-mortem aspectsof organs bear some resemblance to thosenormally seen in vivo, but the longer ittakes after death to observe the structurethe more it changes. Considering the dif-ficulty in studying a fresh cadaver 4 cen-turies ago, early anatomists saw a mor-phological aspect of the structure thatdid not resemble the structure as itexists in the living. It was then thebilabial aspect that was taught as aparadigm and that served as a basis tojustify a valvular mechanism, which hadto be restored surgically when provenfaulty. The surgical techniques thatwere devised to restore the valvular de-

vice were actually causing a change inthe wrong direction: they were creatinga poorer structure, to replace what wasconsidered a faulty living one. Theevidence obtained caused the surgicaltechniques to be abandoned becausethey resulted in irreversible damage tothe terminal ileum.

I began to learn electron microscopyat the University of Washington in 1960,where I had the opportunity to work withthe internationally renowned Dr. E. A.Boyden, on the termination of the bileduct in the horse. A surprise was instore for us! The corresponding struc-ture of the sphincter of Oddi, which we

FIGURE 4. Diagram of the human terminalileum and its papilla protruding into the largeintestine. The circular muscle fibers form thesphincter muscle and the longitudinal musclefibers form the dilator muscle, and both con-stitute the ileal pylorus (from DiDio 1952).

expected to be comparable to the size ofthe animal, was in fact extremely smalland its components very difficult to dis-sect. The explanation became obviouswhen we correlated the findings with thefact that the horse does not possess agallbladder and that the flow of bile iscontinuous, thus not requiring a highlydeveloped musculature at the level ofthe choledochoduodenal junction (DiDioand Boyden 1962).

Later, the proper use of terminologyfor the correct concept originated a luckyresult—another case of serendipity. I


had been toying with the idea of remov-ing the longitudinal component of in-testinal musculature to cause a muscularimbalance and create an artificial or sur-gical sphincter by letting the circularmusculature prevail. I presented theidea to Dr. M. C. Anderson, an associateprofessor of surgery at NorthwesternUniversity, and he reluctantly agreed towatch me attempt to perform the inter-vention in one of the dogs in his experi-mental surgery laboratory. As soon asthe thin longitudinal musculature of theintestine was removed, we both sharedthe moment of witnessing the birth of anartificial sphincter, the confirmation of aprediction and the beginning of a newsuccessful line of research. After thepresentation of the first results at a con-gress of surgery, many compliments were

received, including a left-handed one byan outstanding surgeon: "The techniqueis ingenious, simple, and excellent, but Iwonder why it was not discovered earlierand why it was not a surgeon who hadthe idea first?" No comments then . . .and no comments now.

I published a monograph on the leftrenal vein (fig. 5), which is compressedbetween the superior mesenteric arteryand the aorta by the tip of the pancreaticuncinate process and the duodenum(DiDio 1956). This arterial forceps re-peats the same conditions encountered atthe level of the terminal segment of theleft common iliac vein. I was gratifiedthat my interpretation of the changesoccurring in the left common iliac vein,which had led me to the study of the leftrenal vein, was correct and that there

FIGURE 5. Diagram of the relationship of the left renal vein (VRE) with the du-odenum (D) in the forceps made up by the superior meserteric artery (sectioned)and the aorta (A) in man. The left suprarenal vein (VSRE) is seen as a tributaryof the left renal vein, which ends in the inferior vena cava (VCI) (from DiDio 1956).

202 LIBERATO JOHN A. DiDIO Vol.

was a consistent response in similarstructures.

Impressed by the identification andsurgical importance of the pulmonarysegments and guided by the comprehen-sive view of the human body that I wasattempting to gain, I asked myselfwhether other parenchymatous organswould follow the same segmental mor-phological pattern. I decided to con-centrate on the segments of the kidney,and suggested to my graduate studentsthat they undertake the same investiga-tions on the spleen and liver. Naturedid not disappoint me since in all theseviscera the segmental arrangement, elu-sive at first, was found and provedvaluable for surgical purposes.

It is well known to those involved inscientific research that there is a historyfor each project and for each paper. Itis a personal, emotional history that isnever published but that, once told,helps illuminate obscure issues, shows theorigin of inspiration and the strength ofmotivation. In the case of the studiesof renal segments, it will show how tolose the race against time. I had startedto work intensively on the anatomico-surgical segments of the kidney. By1953, there was no publication on thesubject and I had 28 specimens to docu-ment the findings. Having been ap-pointed chairman of the Department ofAnatomy, the completion of the paperwas slowed down. In England, a yearlater, Graves (1954) published an articleon the anatomy of the intrarenal arteriesand its application to segmental resectionof the kidney, thus rightly becoming thediscoverer of the renal segments. Thisoccurrence shows how detrimental chair-manships are to research. He had justbeat me to the finish line. It was myagony of defeat overwhelmingly com-pensated for by the ecstasy of victorysince our results were identical. Fromthe terminology he had used, I recognizedthat he had been inspired by the seg-ments of ventilation of the lung, as Ialso had been. In fact, he went as far asto call the "apical segment" the "supe-rior territory," as had been adopted forthe lung (DiDio 1961).

I rewrote the monograph, includedGraves' data, and presented it to the

Brazilian Academy of Medicine in 1956.Much later, at the International Con-gress of Anatomy in Wiesbaden (1956),the terminology I had proposed wasadopted in its entirety (Internat. Anat.Nomenclature Comm. 1968). This lineof research proved fruitful and reward-ing. In the spleen, my former studentsdemonstrated the existence of venoussegments (Neder 1958), of the arterialsegments (Zappala 1958), and successfulapplication in humans (Campos-ChristoI960). In the liver, Nogueira (1958)provided the evidence of venous hepaticsegments, and I presented a comprehen-sive view of the segmentations as theanatomical background for partial hepa-tectomy (DiDio 1978, 1980). With oneof my former students, Professor H.Rodrigues, presently chairman of theDepartment of Anatomy at the MedicalSchool in Vitoria (Brazil), I describedthe anatomicosurgical segments of theheart (DiDio and Rodrigues 1978, 1980).

With a fellowship from the RockefellerFoundation in 1960, I first went to theUniversity of Washington, a year laterto Rockefeller University in New York,and then to Harvard Medical School tolearn electron microscopy with leaders inthe new field: Dr. H. Stanley Bennett,Dr. G. E. Palade (who was recentlyawarded the Nobel Prize) and Dr. DonW. Fawcett, respectively. They joinedProfessor Locchi in becoming the quad-rumvirate to whom I owe my scientificcareer. Although excited and fascinatedwith the new and promising technique forthe study of subcellular particles, I keptworking at the macroscopic level. Notingthe lack of clear systematization of theatrial arteries, I decided to study them ina unique series of hearts obtained fromindividuals who had committed suicide.As soon as I began to dissect the arteries,I was surprised to find recurrent vesselsthat did not follow the expected dis-tribution and I considered them ana-tomical variations. In a few days, thevariations became the most frequentpattern, which had been completely over-looked till then. I had discovered a setof vessels that probably had been seenby many anatomists who did not attri-bute any importance to them, perhapsbecause of their size (fig. 6). They are


the atrioventricular and ventriculo-atrialarteries (DiDio 1967a), which establish avascular suture between atria and ven-tricles. The abstract was selected fromamong all the gross anatomy papers andshared the honor of being presented with5 others from each of the anatomicaldisciplines at the plenary session of theAmerican Association of AnatomistsMeeting in Denver (1964).

An electron microscopic study of thefast beating heart of the hummingbird(444/min at rest), among other interest-

FIGURE 6. Diagram of the anterior view of anadult human heart to show the atrioventricular(right) and the ventriculo-atrial (left) branchesof the major branches of the coronary arteries.The arrows point to recurrent vessels originat-ing from an a trial artery (atrioventricular) andfrom a ventricular artery (ventriculo-atrial)(From DiDio 1967a).

ing results, showed one of the largestmitochondria ever seen (DiDio 1967b)and brought to Toledo its first electronmicroscope for the investigation of bio-logical structure.

Having investigated the myocardiumof hummingbirds, I decided to study itsdifferences as compared to the myo-cardium of the slow beating heart of the

sloth (1968). Among the unexpectedresults, the heart of one of the controls,which happened to be a pregnant slothas seen at necroscopy, had alterationsonly in mitochondria—the single patho-logical finding in an otherwise normalmyocardium (fig. 7). I called the de-generation of the mitochondria a mito-chondrosis or mitochondritis (DiDio1971), an example of subcellular pathol-ogy. Faller (1977), working in Switzer-land, recently confirmed this finding inthe pancreas and termed it a mito-chondriosis. At present, the study ofthe male offspring of that pregnant slothis underway to see whether the mito-chondriosis was also present in themyocardium and whether some light canbe shed on this challenging subject.

I began to look at science from otherperspectives, including the perspectiveof art. The study of medicine and itshistory led me to correlate them with artin an attempt to explore the biologicallaws to which painters and sculptors aresubject. This intriguing relationship waspresented under the title "Art, Anatomy,and Medicine" at the International Col-lege of Surgeons in Chicago, and waspublished soon after (DiDio 1971). Thestudy was later extended to the moregeneral relationship between art and sci-ence and, recently, to art, music, litera-ture, religion, including, among othertopics, anatomy in Dante's Inferno,—proving that science can lead one toplaces other than paradise.

These scientific activities have broughtmany honors and benefits; the most re-cent included presiding over the PanAmerican Congress of Anatomy in NewOrleans (1972), during which I becamean honorary citizen of the City of NewOrleans, election as Honorary Presidentof the Pan American Association ofAnatomy, heading the United States'delegation to the 3rd International Sym-posium on the Morphological Sciences inTelAviv (1977), having been President ofthe IV International Symposium on theMorphological Sciences in Toledo (1979),and receiving the Anatomist of the YearAward (1979), having been President ofthe Ohio Academy of Science and havingpresided over this exciting annual meet-ing.


FIGURE 7. Electron micrograph of the ventricular myocardium of a pregnant sloth displaying4 onionoid bodies (corpora cepiformia), 3 of which are arranged in a longitudinal row similarlyto mitochondria, the sites of which they appear to occupy. The periphery of the smaller, iso-lated onionoid body (corpus cepiforme) exhibits remnants of mitochondrial cristae, providingevidence in this case of the mitochondrial origin of these bodies. X22.750 (from DiDio 1970).

If by mentioning the highlights of mycareer, a single student in attendance de-cides to become a scientist, all the sins Ihave committed this evening, especiallypride, not to mention gluttony, wereworth committing. I learned that noone should be reluctant to say he isright, as I did this evening, disregardingtrue or false modesty. The reward forwork well done is more work. Judgingby the amount of work facing me, I can-not complain. In sharing with you somebehind-the-scences happenings, I wasable to say when I was wrong. If youfind an old scientist who is afraid to saythat he is wrong, then he still needs togrow up.

In closing, it is a pleasure to state that,with the wondrous help of serendipity, itwas worth spending almost half a centurystudying medical sciences. The search

for scientific truth, whether or not youdiscover anything, is forever important.

LITERATURE CITEDCampos-Christo, M. C. 1960 Splenectomies

partielles reglees: a, propos de 3 cas operes.Presse Med. 68: 485-486.

DiDio, L. J. A. 1942 Observations on Whit-nall's "orbital tubercle" on the malar bonein man. Anais Fac. Med. Univ. Sao Paulo18: 43-64.

1943 Manganese in Brazilian foods.Hospital 24: 381-388.

1944 Manganese content in foods.Rev. Medicina 28: 315-336.

1949 Normal and pathological struc-tures on the inner surface of the left commoniliac vein. Arq. Cir. Clin. Experim. 12: 507-616.

1952 Ileo-ceco-colic pylorus and pa-pilla. Rev. Hosp. N. S. Aparec, Sao Paulo5: 191-442.


— _ - 1956 Applied anatomy of the renalveins. The importance of the aortico-mesenteric forceps. The renal segments.Anais Fac. Med. Univ. Minas Gerais 16: 51-202.

1961 Anatomicosurgical vascular seg-ments of the human kidney. Anat. Rec. 139:299.

1962 The presence of the eminentiaorbitalis in the os zygomaticum of HinduSkulls. Anat. Rec. 142: 31-40.

1967a The atrioventricular branchesof the human coronary arteries. J. Morphol.123: 397-404.

- 1976b Myocardial ultrastructure andelectrocardiograms of the hummingbird un-der normal and experimental conditions.Anat. Rec. 159: 335-352.

1968 Myocardial ultrastructure andelectrocardiograms of the sloth under normaland experimental conditions. J. Morphol.124: 1-21.

1970 Electron microscopic study ofonionoid bodies (corpora cepiformia) in themyocardium of Bradypus tridactylus. J.Submicr. Cytol. 2: 147-155.

1971 Myocardial mitochondrosis ormitochondritis: an electron microscopicstudy. Ateneo Parmense Acta Biomed. 42:359-399.

1971 Art, Anatomy and Medicine.Internat. Surg. 56: 311-324; 381-391.

1978 The anatomical background forpartial hepatectomy. Proceed., 5th PanAmerican Congress of Anatomy, Sao Paulo,Brazil 198-204.

1980 Segments of the liver: the ana-tomical basis for partial hepatectomy. In:Motta, P. and DiDio, L. J. A. (eds.) ModernHepatology. M. Nijhoff Publ. Den Hague,

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