Microsoft Word - 1.MuresanGh_StefanTristanIacob.doc Romanian Neurosurgery (2010) XVII 4: 383 – 387 383 Stefan Tristan Iacob - Founder of Neurosurgery in Cluj Gh. Mureşan, I.St. Florian, Izabella Kasza A complex an outstanding personality, Assoc. Prof. Stefan Tristan Iacob was the one who not only founded but more than that he developed and marked the future progress of Neurosurgery in the university center of Cluj for many decades after his disappearance. Stefan Tristan Iacob was born in Sibiu, on the 20th January 1920 where he attended elementary school (1927-1931), after that the military high school in Targu- Mures (1931-1939) and the Faculty of Medicine in Bucharest at the Medical- Military Institute in the period of 1939- 1945. Between 1940-1945 under the supervision of Dr. O. Arama, head of the Bucharest Central Military Hospital he attended training in neurology. During the war he worked as an intern at the Bucharest Central Military Hospital and in hospitals from Sibiu, Cernavoda, and Constanta. During his neurology training he gathered clinical material and elaborated together with Dr. Grigorescu the monography entitled Neuropathology of the war, published in 1943. The volume was prefaced by Prof. N. Ionescu-Siseşti and it was rewarded by the Romanian Academy with the Oroveanu Prize in 1945. The book was technically edited under exceptional conditions, thus covering especially medical issues, but also social ones. The authors introduced the notion of the disease after being wounded and raised an original conception above history, underlining the major importance of the physic of the nervous disturbances appeared during the war. In 1946 he quit the army and advised by the O Arama, Dr. Iacob dedicated himself to neurosurgery. With the help of Prof. Dumitru Bagdasar he was named as a resident doctor at the Neurosurgery Clinic in Bucharest, administrated by Gen. Dr. P. Costescu. As a resident of neurosurgery in the period of 1946-1949 under the supervision of Prof. C. Arseni, he published together with him the volume entitled Vertebral sciatica, dedicating it to Prof. Dimitrie Bagdasar. In the autumn of 1948 Dr. Iacob was transferred as resident to the Neurosurgery Clinic in Targu-Mures, administrated by Prof. Dr. Dezso Miskolczi şi Tibor Andrasofszky. During this period he translated from Spanish the book entitled „Reglas y consejos sobre investigacion cientifica” written by Ramon Santiago Cajal. The translation was published in 1967 and was very well received by the Superior Council of the Spanish Scientific Research and by the Institute of Cajal. In the fall of 1949 in Cluj he completed his resident training and was transferred to Cluj. Except with a short period between 1941 -1943, when Prof. Dr. Istvan Kornyei 1949 from Hungary performed some neurosurgical interventions, no deparment existed in Cluj for the surgical treatment of the diseases of the nervous system. After arriving in Cluj, he started his medical activity having 2 beds at the 1st Surgical Clinic. The first two surgeries 384 Gh. Mureşan et al Stefan Tristan Iacob performed on the 3rd of October 1949 were two cases of lumbar disc herniation, Dr. Iacob being assisted by Prof. Aurel Nana himself, at that time the head of 1st Surgical Clinic. In November 1949 with the aid of Prof. Dezideriu Duma, the head of the Neurology Clinics, he obtained two wards of 10 beds each within the Neurology Clinics. Since August 1950 by an Order of Ministry of Health the actual building was dedicated to Neurosurgery, which had one Operating Room, the same place where Prof. Istvan Kornyei performed his neurosurgical procedures between 1941 and 1943. Being interested in the progress of specialty, progressively Dr. Iacob succeeded in endowing the clinic monopolar coagulation, electroencephalograph and a Lysholm craniograph. Arteriography was applied by Dr. Iacob and his collaborators in 1952. Prone position for posterior fossa tumors was also introduced by Dr. Iacob together with Dr. Istvan Balint and Dr. Gheorghe Muresan, this novelty being a nationwide exclusivity. It is also to be mentioned that starting with 1965 two of doctors have been working abroad (Dr. Ladislau Steiner, who is the outmost authority in Gamma Knife). Dr. Iacob accorded major attention to the cranio-cerebral neurotraumatology, which has generated the appearance in 1971 of the handbook entitled Emergencies in neurotraumatology- practical handbook, elaborated exclusively based on the clinical material of the department where more than 3000 cases of the nervous system traumas were assisted. Dr. Iacob was interested not only in the progress of specialty but also in development of training in the specialty. In the period of 1949-1952 Dr. Iacob was an assisting professor and then Assoc. Prof. in the period of 1950-1954. Dr. Iacob gave around 100 lectures about neuropathology and neurosurgery. In the period of 1951- 1952 dr. Iacob held 30 courses for the students of the Faculty of Medicine, the 6th year, based on his own iconographic and clinic material. He insisted on the paraclinic examinations (ventricuography, arteriography), methods which were not in use until 1949 in Cluj. For that period this was certainly and obvious progress. Between 1953-1954 Dr. Iacob held a series of 20 courses addressed to internist doctors referring to the practical problems in neurosurgery important for the general practitioner or for doctors of other specialties. These conferences were presented within the Postgraduate Institute of Perfection for the Doctors in Cluj (the Department of Prof. Iuliu Hatieganu). Romanian Neurosurgery (2010) XVII 4: 383 – 387 385 In 1968 Dr. Iacob was hired full time at the Institute of Medicine and Pharmacy Cluj and sustained two courses at the Postgraduate Institute of Perfection for the Doctors in Cluj. In 1969 this course is repeated with a new series. In 1970 Dr. Iacon was named Assoc. Prof. with entire rights at the 2nd Surgical Department, the discipline of neurosurgery. Thus the Neurosurgical Clinic becomes a university clinic and methodological center as well for the issues of neurosurgery in Cluj, Crisana and Maramures counties. During the conferences the following subjects were covered: the modern principles of neuropathology and neurosurgery, the possibilities and horizons of the rahi-medullar surgery, the vertebral sciatica, and especially the isolation of the group of surgical sciatica, the onset of symptoms in neuropathology, the syndrome of surgical emergencies in neuropathology, the value of interrelations among symptom-pathogen-etiology for the early diagnosis of an active surgical therapy, the neuroanatomic value of the approaches of the brain and its vascularization for establishing the neurosurgical approach, the compared value of the clinical and paraclinical diagnosis methods in neuropathology, and neurosurgery as method of scientific research. Outstanding personality Dr. Ştefan Tristan Iacob had a prolific research activity contributing to the perfection of the therapy and diagnosis in neurosurgery. 386 Gh. Mureşan et al Stefan Tristan Iacob Under his supervision in the period of 1950-1969 more than 280 very valuable theses were elaborated. Some of these papers are original in the Romanian specialty literature: Brain arteriography Consideration on 2000 cases accompanied by an album of neuroanatomy and vascular neuroradiology, this study representing the synthesis of the brain arteriography practice in the clinic; The occlusion of the carotid and his branches Consideration on 100 cases; Brain aneurysms and angiomas Consideration on 100 verified cases. A highly appreciated is The atlas of functional neroanantomy (special consideration to the cerebral vascularization). Using the approaches in neurosurgery a series of pieces were prepared, which highlight the different cerebral regions, as they can be seen on live demonstrations. Later they were taken photos of with a special technique; the assemblies of these constitute an album to orient the doctor in the different regions of the nervous system. These papers on the cerebral arteriograph and neuroanatomy of the cerebral vascularization were highly appreciated by Prof. I. T. Niculescu at the 18th Conference of Neurology-Psychiatry and Neurosurgery in 1955, who recommended these to the president of the Romanian Academy for publication. In 1964 Dr. Iacob successfully represented Romania with 3 papers, reflecting the electroencephalographic studies performed in the clinic sent to 3 important scientific congresses (The 8th International Congress of Thoracic Diseases, Mexico electroencephalographic changes in hypoxia , The 4th Congress of EEG, Szeged, Hungary, EEG correlations and brain metabolism in the neuronal dystrophies, Purkinje International Congress, Prague, Czech Republic). The paper entitled Syndromes d’ insuffisence circulatoire cerebrale par occlusions vasculaires dans les tumeurs cerebrales” a comparative study on 2000 cerebral arterioraphies was presented at The 3rd European Congress of Neurosurgery in Spain and Portugal (Madrid, Lisabona) in the period of the 23rd -26th April 1967. At this event a photo exhibition of 60 original photos also took place and it was entitled „Methode correlative neuroanatomique et arteriographique pour la visualisation cerebrale” signed by Dr. Stefan Trsitan Iacob, Dr. M. Ionescu, Dr. Gheorghe Mureşan and reflecting the effectuated studies by these using the method of the brain arteriography. At the Neurosurgery Clinic, Dr. Iacob performed an original research studying crystalographically the normal and pathologic CRL. The material of this research was presented at the 4th International Congress of Neurosurgery, New York, in the period of the 22nd -26th September 1969. The presentation was based on 2500 preparations and a photo album. The study was entitled Crystalline structures in the CRL and their practical meaning. In 1973 at the 5th International Congress of Neurosurgery held at Tokyo, Dr. Iacob presented the paper entitled Vascular traumatic lesions, surgical and non-surgical considerations on 1072 cases. The paper is a synthesis and also the result of a long-term activity in neurotraumatology on 3000 cases admitted in a period of 20 years. Between 1949-1969 under the supervision of dr. Iacob the following doctors elaborated their PhD thesis: Prof. Dr Ladislau Steiner (Prefrontal Romanian Neurosurgery (2010) XVII 4: 383 – 387 387 leucotomy – 1950) and Prof. Dr. Asgian Berdj (The modern semiologic integration of the grabbing reflex-1950). Outstanding personality Dr. Stefan Tristan Iacob imposed himself with the lesson of passion dedicated to the idea of neurosurgery, by his professional probity, through his scientific concerns, and by his original conception impregnated to the school of neurosurgery in Cluj. The tradition kept alive since then formed the present generation of neurosurgeons. Thus the relay was handed over and on it Ambroise Parre’s aphorism is written, namely LABOR IMPROBUS OMNIA VINCIT. Selective references 1. Arseni, Constantin, Momente din istoria Neurochirurgiei Româneşti, Bucureşti, Ed. Academiei RSR, 1988; 2.Crişan. Virgil, Dr. St. T. Iacob (1920-1975) Creatorul serviciului de Neurochirurgie din Cluj-Napoca, Revista Clujul Medical, 1986, nr. 59, volum 4, p. 356; 3.Florea, L. , -Liviu, V., Bilanţul a două decenii. Muncitorul sanitar, anul XXI, nr. 49 (1017), 2 decemvrie 1969; 4. Şt. T. Iacob, - Grigorescu, D., Neuropatologie de război, Sibiu, Kraft und Drotleff s.a., 1945, 224 pagini, 60 ilustraţii; 5. Iacob, Şt. T, - Arseni, C., Sciatica vertebrală, Sibiu, Ed. Velter, 1948, 200 pag., 165 figuri; 6. Iacob, T&. Şt., Memoire d’activite- expose des travaux scientiques, 1965, 35 pagini; 7. Iacob, T. Şt., Urgenţe în neurotraumatologie- îndreptar practic, ed. Direcţia Sanitară Jud. Cluj, 1971, 300 pagini; 8. Kailan, Ana Maria, Neurochirurgia la Cluj (lucrare de diplomă), 1992; 9. Marian Ion, A fost dată în folosinţă noua secţie de neurochirurgie, Ziarul Făclia, anul XV, nr. 4368 din 11.11.1960; 10. Marin, Fl., Facultatea de Medicină, Şcoala Medicală Clujană şi Spitalele din Cluj (1500-1990), Ed. Casa Cărţii de Ştiinţă Cluj, 2004, pag. 526-528; 11. Mureşan, Gheorghe, 45 de ani de Neurochirurgie Clujană, „Adevărul de Cluj “ 8-9 novembrie, 1997, pag. 6.