Lives in Distress
Lives in Distress
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生活在困境中
DOI：
10.1136/bmj.2.5470.1109-c
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发表时间：
1965
影响因子：
--
通讯作者：
J. Agate
中科院分区：
文献类型：
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作者：
J. Agate
这本来自南希学院的专著论述了与甲状腺功能障碍有关的肌肉疾病。这可能是唯一一本在这一领域如此全面地涵盖了这一领域的书。良好的临床帐户给出的条件，这无疑是由于甲状腺疾病，如急性和慢性甲状腺毒性肌病。甲状腺毒症和周期性家族性麻痹之间的关系也有很好的解释，在日本的发病率高得惊人。不少于250个已公布的病例来自该国，而在欧洲和美国总共只有30个病例。作者还提到重症肌无力和甲状腺毒症之间的联系，他们不相信所谓的跷跷板关系，即如果甲状腺毒症得到治疗，肌无力就会恶化。他们在文献中找到了强有力的支持，认为这两种疾病的表现往往相当独立。在考虑所有这些情况时，作者主要依据已发表的材料，并对这些材料进行了充分的分析和讨论。他们自己的经验贡献不大。他们特别感兴趣的是在诊断甲状腺功能障碍时踝关节痉挛的持续时间。他们使用毫秒（ms）测量。从肌腱敲击的时刻到松弛梯度一半的点。使用该经验终点是因为弛豫结束在跟踪上是模糊的，并且不能精确定义。毫无疑问，两者有相当大的重叠，因此25%的甲状腺功能亢进患者在可疑的260-280 ms范围内，而多达30%的粘液水肿患者在同样可疑的320-360 ms范围内。因此，该测试的诊断价值在排除而不是证明特定的甲状腺功能障碍方面更大。作者得出结论，“跟腱造影“与放射性碘摄取一样可靠，优于B.M.R.。和血清胆固醇。当治疗结果在一段时间内被跟踪时，该测试在给定患者中也是可靠的。这本书有一个广泛的参考书目，不少于705参考被给予。盎格鲁-撒克逊和德国的文学作品被广泛而准确地引用，当然还有法国的。作为一本参考书，它对神经学家和内分泌学家都有很大的价值。
This monograph from the School of Nancy deals with muscular disorders associated with thyroid dysfunction. It is perhaps the only book to cover the ground so fully in this field. Good clinical accounts aregiven of the conditions which are undoubtedly due to thyroid disorder, such as acute and chronic thyrotoxic myopathy. There is also a good account of the relationship between thyrotoxicosis and periodic familial paralysis, with its surprisingly high incidence in Japan. No fewer than 250 ot the published cases come from that country, whilst only 30 have been recorded in Europe and the United States altogether. The writers also refer to the association between myasthenia gravis and thyrotoxicosis, and they side with those who do not believe in the so-called see-saw relationship by which myasthenia is said to worsen if the thyrotoxicosis is treated. They find strong support in the literature for the view that the two disorders often behave quite independently of each other. In considering all these conditions the authors base themselves mainly on published material, which they analyse and discuss fully. There is little contribution from their own experience. Their particular interest has been the duration of the ankle jerk in the diagnosis of thyroid dysfunction. They have used the measurement in milliseconds (ms.) from the moment of percussion of the tendon to a point half-way down the relaxation gradient. This empirical end-point was used because the end of relaxation is blurred on the tracing and cannot be precisely defined. Undoubtedly there is a fairly wide overlap, so that 25%/ of hyperthyroid patients are in the doubtful 260-280 ms. range, whilst as many as 30% of myxoedematous patients are in the equally doubtful 320-360 ms. range. The diagnostic value of the test is therefore greater in excluding rather than in proving a given thyroid dysfunction. The authors conclude that the " achillogram " is reliable as radioiodine uptake and better than the B.M.R. and the serum cholesterol. The test is also reliable in a given patient when the results of treatment are being followed over a period. This book has an extensive bibliography, no fewer that 705 references being given. The Anglo-Saxon and German literatures are widely and accurately quoted as well as, of course, the French. As a reference book it will be of great value to the neurologist as well as the endocrinologist.