Fritz Köberle (b. October 1st, 1910, Eishgraben, Austria, d. February 20th, 1983, Americana, Brazil), Austrian-Brazilian physician, pathologist and scientist, discoverer of the neurogenic mechanism of the chronic phase of Chagas disease, a human parasitic disease caused by Trypanasoma cruzi, a protozoan. October 1 is the 274th day of the year (275th in Leap years). ... 1910 was a common year starting on Saturday (see link for calendar). ... The Republic of Austria ( German: Republik Österreich) is a landlocked country in Central Europe. ... February 20 is the 51st day of the year in the Gregorian Calendar. ... Americana refers to artifacts of unmistakably American culture. ... The Federative Republic of Brazil (República Federativa do Brasil in Portuguese) is the largest and most populous country in South America, and fifth largest in the world. ... The word physician should not be confused with physicist, which means a scientist in the area of physics. ... Pathology (in ancient Greek pathos = feeling, pain, suffering and logos = discourse or treatise, i. ... A scientist is a person who is expert in an area of science and who uses scientific methods in research. ... Chagas disease (also called American trypanosomiasis) is a mammalian disease occurring only in the Americas. ... Genera Blastocrithidia Crithidia Endotrypanum Herpetomonas Leishmania Leptomonas Phytomonas Trypanosoma Wallaceina The trypanosomes are a group of kinetoplastids that only have a single emergent flagellum. ... Protozoa (in Greek protos = first and zoon = animal) are single-celled creatures with nuclei that show some characteristics usually associated with animals, most notably mobility and heterotrophy. ...

Life

Fritz Köberle studied medicine at the University of Vienna, Austria, graduating magna cum laude in 1934. He began to work in the Institute of Pathology while a student and soon after graduation, in 1935, he was admitted as an assistant professor. With the annexation of Austria to Germany (Anschluss) by Adolf Hitler, Köberle was drafted into the Army as a medical lieutenant and worked as a pathologist in the Central Army Hospital of Vienna. With the outbreak of the Second World War hostilities, Köberle was attached as field pathologist to the XII Army Group of the Wehrmacht in 1940 and served in the fronts of France, Belgium, Poland and Russia. He was able to acquire during this period an enormous experience on the pathology of infectious diseases (bacterial dysentery, typhus, typhoid fever, tularemia and malaria) as well as war-inflicted wounds, and performing more than four thousand autopsies. After the war, Köberle returned to the University of Münster as Privatdozent, continuing his activities as professor and researcher of medical pathology until 1945. He returned shortly to the University of Vienna, and, in 1946, accepted a post as director of the Serological and Pathological Institute of the General Hospital of St. Polten, Lower Austria. See drugs, medication, and pharmacology for substances that are used to treat patients. ... The University of Vienna (German: Universität Wien) was founded in 1365 by Rudolph IV and hence named Alma mater Rudolphina. ... Latin honors are Latin phrases used to indicate the level of academic distinction with which an academic degree was earned. ... The general German term Anschluss is part of the specific political incident Anschluss Österreichs referring to the inclusion of Austria in a Greater Germany in 1938. ... The Wehrmacht (literally defence force or means/power of resistance) was the name of the armed forces of Germany from 1935 to 1945. ... The Republic of Poland, a democratic country with a population of 38,626,349 and area of 312,685 km², is located in Central Europe, between Germany to the west, the Czech Republic and Slovakia to the south, Ukraine and Belarus to the east, and the Baltic Sea, Lithuania and... In medicine, infectious disease or communicable disease is disease caused by a biological agent (e. ... Dysentery is a severe diarrhea illness often associated with blood in the feces. ... This is about the disease Typhus. ... This is about the disease typhoid fever. ... Tularemia (also known as rabbit fever) is a infectious disease caused by the bacterium Francisella tularensis. ... Red blood cell infected with Malaria (Italian: bad air; formerly called ague or marsh fever in English) is an infectious disease which causes about 500 million infections and 2 million deaths annually, mainly in the tropics and sub-Saharan Africa. ... A wound is a physical trauma where the skin is torn, cut or punctured. ... For the former Death Metal band called Autopsy, see Autopsy (band). ... The University of Münster ( German Westfälische Wilhelms-Universität Münster, WWU) is a public university located in the city of Münster in Germany. ... Privatdozent (PD or Priv. ...

In 1952, he received an invitation which would radically change his personal and scientific life. A new medical school was being established by the University of São Paulo in the little-known city of Ribeirão Preto, in the hinterland of the state of São Paulo, Brazil. The main objective of the state government was to increase the number of physicians in the rapidly developing hinterland, and its first dean, Dr. Zeferino Vaz, a parasitologist, medical research and professor of the University, wished to create a favorable environment for high quality medical research and teaching in the new school. With this in mind, Vaz invited a number of foreign researchers to become chairmen of the basic and clinical departments, and Fritz Köberle had a good recommendation by Prof. Henrique da Rocha Lima, a Brazilian medical researcher who had studied in Germany. Dr. Köberle accepted an invitation and moved with his family to the Medical School of Ribeirão Preto in 1953. He soon organized the Department of Pathology, became its chairman, and began to assemble a small group of Brazilian researchers. Medical school generally refers to a tertiary educational institution (or part of such an institution) which is involved in the education of future medical practitioners (medical doctors). ... The University of São Paulo (Universidade de São Paulo, USP) is one of the three public universities funded by the State of São Paulo. ... São Paulo is a state in Brazil. ... The Federative Republic of Brazil (República Federativa do Brasil in Portuguese) is the largest and most populous country in South America, and fifth largest in the world. ... Parasitology is the study of parasites, their hosts, and the relationship between them. ... Medical research is research conducted to aid the body of knowledge in the field of medicine. ... Faculdade de Medicina de Ribeirão Preto (Faculty of Medicine of Ribeirão Preto in Portuguese) is a medical school of the University of São Paulo located in the city of Ribeirão Preto, state of São Paulo, Brazil, founded 1952. ...

Works

While in Ribeirão Preto, Prof. Köberle noted that a promising field of research in pathology for the new department and himself could be Chagas disease, or American trypanosomiasis, which had been discovered by another Brazilian physician named Carlos Chagas, in 1910 (coincidentally, the year he was born). Even though 40 years had passed since its discovery, little was known about the peculiar manifestations of the chronic phase of the disease, such as megaesophagus, megacolon, cardiomegaly, heart ventricular aneurysm, achalasia, etc., and the mechanism of the causation of these several pathologies. By making good use of the extensive caseload of fatalities due to Chagas disease in the region of Ribeirão Preto and Southern Minas Gerais, where it was endemic and widely prevalent at the time, Köberle studied initially the dilation pathologies of the digestive tract and proved, by extensively quantifying the number of neurons of the autonomic nervous system in the Auerbach's plexus, that: 1) they were strongly reduced all over the digestive tract; 2) that megacolon and megaesophagus appeared only when there was a reduction of over 80% and 55% of the number of neurons, respectively; 3) these pathologies appeared as a result of the disruption of the neurally integrated control of peristalsis (muscular annular contraction) in those parts where a strong force is necessary to impel the luminal bolus of food or feces; and 4) European idiopathic megaesophagus and Chagas megaesophagus appeared to have the same etiology, namely the degeneration of the Auerbach's myoenteric plexus. Chagas disease (also called American trypanosomiasis) is a mammalian disease occurring only in the Americas. ... Carlos Chagas Carlos Justiniano Ribeiro Chagas (born July 9, 1879, Oliveira, Minas Gerais, Brazil; died November 8, 1934, Rio de Janeiro), was a Brazilian physician. ... 1910 was a common year starting on Saturday (see link for calendar). ... Medicine In medicine, a persistent and lasting condition is said to be chronic (from Greek chronos). ... Megaesophagus is a condition (in dogs) where peristalsis fails to occur properly and the esophagus is enlarged. ... Achalasia or acalasia is a failure of a ring of muscle (as a sphincter) to relax (completely). ... Minas Gerais is one of the states of Brazil, the second most populous in the federation. ... For the Physics term GUT, please refer to Grand unification theory The gastrointestinal or digestive tract, also referred to as the GI tract or the alimentary canal or the gut, is the system of organs within multicellular animals which takes in food, digests it to extract energy and nutrients, and... Neurons (also called nerve cells) are the primary cells of the nervous system. ... Anatomy and Physiology of the A.N.S. In contrast to the voluntary nervous system, the involuntary or autonomic nervous system is responsible for homeostasis, maintaining a relatively constant internal environment by controlling such involuntary functions as digestion, respiration, and metabolism, and by modulating blood pressure. ... Peristalsis is the process of involuntary wave-like successive muscular contractions by which food is moved through the digestive tract. ... A bolus is a large dose of a drug that is given (usually intravenously by direct infusion injection or gravity drip) at the beginning of treatment to raise blood-level concentrations to a therapeutic level. ... Feces (also spelled faeces or fæces) are the waste products from the digestive tract expelled through the anus during defecation. ... Idiopathic is a medical adjective that indicates that a recognized cause has not yet been established. ... Megaesophagus is a condition (in dogs) where peristalsis fails to occur properly and the esophagus is enlarged. ... Etiology (alternately aetiology, aitiology) is the study of causation. ... The idea of degeneration had a huge influence or science, art and politics from the 1850s to the 1950s. ...

Studying the typical features of the Chagasic myocardium pathology, characterized by damage to its electrical conduction pathways, heart arrythmia, aneurysm of the ventricular apex, cardiomegalia and sudden death by ventricular fibrillation, Köberle and his group of collaborators were able to prove that they were caused also by an extensive denervation of the parasympathetic (55% and sympathetic (35%) intrinsic cardiac nervous networks, leading to a control imbalance of contraction, cardiac failure, cardiomegalia and hypoxia. He named this constellation of effects as cardiopathia parasympathicopriva. Other less typical phenomena observed in Chagas disease, such as bronchiectasis and myelopathy were also studied by Köberle under the new prism of his neurogenic theory. Myocardium is the muscular tissue of the heart. ... An aneurysm (or aneurism) (from Gr. ... Ventricular fibrillation (V-fib) is a cardiac condition which consists of a lack of coordination of the contraction of the muscle tissue of the large chambers of the heart. ... Anatomy and Physiology of the A.N.S. In contrast to the voluntary nervous system, the involuntary or autonomic nervous system is responsible for homeostasis, maintaining a relatively constant internal environment by controlling such involuntary functions as digestion, respiration, and metabolism, and by modulating blood pressure. ... The word sympathetic means different things in different contexts. ... Congestive heart failure (CHF) (also called heart failure) is the inability of the heart to pump blood effectively to the body, or requiring elevated filling pressures in order to pump effectively. ... Hypoxia has several meanings: Hypoxia is the lack of oxygen in tissues, see Hypoxia (medical) Hypoxia is the lack of oxygen in a water body leading to the death of organisms, see Hypoxia (water) This is a disambiguation page — a navigational aid which lists other pages that might otherwise share... Bronchiectasis is a condition in which the bronchi of the lungs become dilated in response to obstruction. ... Spinal cord injury, or myelopathy, is a disturbance of the spinal cord that results in loss of sensation and mobility. ...

Thus, with his classical and detailed scientific studies, Köberle proposed for the first time a unified and radically different (and polemical) view of the etiopathogeny of Chagas disease, characterizing it as a disease of the autonomic nervous system, which establishes itself during the acute phase and provokes long term and slowly installing denervation. Since the trypanosoma does not seem to damage neurons directly, Köberle and other reserchers have hypothesized the action of a neurotoxin, cytotoxic factors or autoimmune mechanisms. This page is not about the diacritic character; see acute accent for more information. ... A neurotoxin is a toxin that acts specifically on nerve cells, or neurons, usually by interacting with membrane proteins and ion channels. ... Cytotoxicity is the quality of being poisonous to cells. ... Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. ...

Dr. Köberle retired from the University of São Paulo in 1976, but soon moved as visiting professor to the Medical School, of the State University of Campinas, in Campinas, São Paulo, where one of his sons, Gottfried Köberle, is a professor of Orthopedics. He worked there until his death, in 1983. Another son, Roland Köberle, is a professor in computer sciences of the University of São Paulo at São Carlos. The State University of Campinas (Universidade Estadual de Campinas, shorlty Unicamp) is one of the public universities of the State of São Paulo, Brazil. ... Campinas is a city and county (município) located in the state of São Paulo, Brazil. ... Orthopedic surgery or orthopedics (BE: orthopaedics) is the branch of surgery concerned with acute, chronic, traumatic and recurrent injuries and other disorders of the locomotor system, its musclular and bone parts. ... Computer science (informally: CS or compsci) is, in its most general sense, the study of computation and information processing, both in hardware and in software. ...

Bibliography

• Koeberle, F. Cardiopathia parasympathicopriva. Munch. Med. Wochenschr.. 1959 Jul 31;101:1308-10.
• Koeberle, F. Enteromegaly and cardiomegaly in Chagas disease. Gut. 1963 Dec;41:399-405.

External link

• Rezende, J.M.: Fritz Köberle and his studies on Chagas Disease (http://usuarios.cultura.com.br/jmrezende/Koeberle.htm) (in Portuguese)