Prescience of a surgeon in 1980.
Prescience of a surgeon in 1980.
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1980 年一位外科医生的先见之明。
DOI：
10.1089/thy.2012.0636
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
McLachlan,SandraM
中科院分区：
文献类型：
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作者：
McLachlan,SandraM
最近，鲍里斯·卡茨博士给了我一份未发表的文件的影印件，这份文件的标题是塞尔文·泰勒的《甲状腺和胸腺》。泰勒在甲状腺领域广为人知，在1978年退休之前，他一直是伦敦哈默史密斯医院皇家研究生院的外科医生和院长。(顺便说一句，外科医生在英国被称为先生，而不是博士。)这一页的开头是泰勒1980年作为国际内分泌外科医生协会首任主席时的讲话。因为上面写着“不供出版”，并附上了他的签名，所以我转述了一下。泰勒说，他选择讨论一个让他在从医生涯的大部分时间里既感兴趣又担心的话题。接下来的段落，关于Graves病的甲状腺特征及其对治疗或解决眼球突出的影响，提供了显著的预见性。泰勒描述了一些有趣的未发表的实验，这些实验涉及使用普奈洛尔治疗的甲亢患者的甲状腺放射自显影(在注射放射性碘后)。甲亢患者可能是由Graves病或毒性结节性甲状腺肿引起的。他观察到两种类型：有广泛淋巴浸润性腺体和无淋巴浸润性腺体。在后一组中，放射自显影显示了更大程度的“变黑”。放射自显影术中更广泛的变黑意味着淋巴细胞较少的腺体中的甲状腺细胞对放射性碘的摄取更大。如果我们知道泰勒的经历，我和我的英国同事就会引用他的观察结果，对格雷夫斯病患者手术前服用心得安和抗甲状腺药物治疗的甲状腺浸润性淋巴细胞的甲状腺自身抗体合成进行比较。这项研究和其他一些研究(下面引用了一些)之所以成为可能，是因为我和我的同事们与另一位好奇的外科医生--英国诺丁汉大学的克里斯托弗·佩格先生--的宝贵合作。它是在1983年欧洲甲状腺协会马德里会议上提出的。午休时，当几名埃塔成员在游泳池里晒太阳时，我听到克里斯大声思考：“我想知道甲状腺里的那些淋巴细胞在做什么？”
A photocopy of a page from an unpublished document, entitled ‘‘The Thyroid and the Thymus’’by Selwyn Taylor, was recently given to me by Dr. Boris Catz. Mr. Taylor, as is well-known in the thyroid field, was a surgeon and Dean of the Royal Postgraduate Medical School, Hammersmith Hospital, London, until his retirement in 1978.(Incidentally, surgeons are addressed as ‘‘Mr.’’and not ‘‘Dr.’’in the United Kingdom.)The page begins with Mr. Taylor’s address in 1980 at the end of his year as the first president of the International Association of Endocrine Surgeons. Because it is inscribed ‘‘Not for publication’’accompanied by his signature, I have paraphrased it. Mr. Taylor says he has chosen to discuss a subject that has interested and worried him for most of his medical life. The subsequent paragraph, concerning characteristics of the thyroid in Graves’ disease and its implications for treating or resolving exophthalmos, provides remarkable prescience. Mr. Taylor describes intriguing unpublished experiments involving autoradiographs (after radioactive iodine administration) from thyroid glands of patients with hyperthyroidism, presumably due to Graves’ disease or toxic nodular goiter, treated with propranolol. He observed two categories: glands with extensive lymphoid infiltration and those without. In the latter group, the autoradiograph demonstrated a greater degree of ‘‘blackening.’’More extensive blackening in autoradiography implies a greater uptake of radioactive iodine by thyrocytes in glands with fewer lymphocytes. Had we been aware of Mr. Taylor’s experience, my British colleagues and I would have cited his observations in our comparison of thyroid autoantibody synthesis by thyroid-infiltrating lymphocytes from Graves’ patients treated before surgery with propranolol versus antithyroid drugs (1). This and other studies (some cited below) were possible because of the invaluable collaboration my colleagues and I enjoyed with another inquisitive surgeon, Mr. Christopher Pegg, University of Nottingham, United Kingdom. It was initiated at the 1983 Madrid meeting of the European Thyroid Association. In the lunch break, while several ETA members were sunning themselves at the swimming pool, I heard Chris ponder aloud,‘‘I wonder what all those lymphocytes in the thyroid are doing?’’