背景:WalterE.Dandy(1886-1946)是一位杰出的神经外科医生,他的整个职业生涯都在约翰霍普金斯医院度过。1910年从医学院毕业后,他与HarveyCushing一起在Hunterian实验室完成了研究奖学金,然后以住院医师的身份加入了外科系。1931年升任教授.丹迪做出了几项贡献,帮助建立了神经外科专业,最著名的是引入肺室造影来成像脑部病变,为此他获得了诺贝尔奖提名。他还做了很多垂体手术,尽管他在这一领域的角色鲜为人知,并被库欣的角色所掩盖。
目的:这项回顾性队列研究旨在揭示Dandy的垂体工作,并将其置于约翰霍普金斯医院进行的整体垂体手术的背景下。
方法:通过筛选病理科的纸质和电子手术病理记录,获得垂体手术资料,以及位于切斯尼医疗档案中的约翰·霍普金斯医院的普通手术室日志。
结果:在1902年2月至2017年7月期间,共进行了3211例与病理标本相关的垂体手术,共2847例患者。大多数手术(321189%中的2875例)由21名神经外科医生完成。丹迪的手术数量排名第四,在35年的活动中进行了287次垂体手术。他平均每年进行8次垂体手术,这个比率使他在所有霍普金斯神经外科医生中排名第六。除了他在1912年7月完成的第一次手术,库欣还在霍普金斯,Dandy经颅接近脑垂体,而不是跨卵。大多数Dandy的垂体患者病理诊断为垂体腺瘤,其次是颅咽管瘤和鞍区囊肿。在丹迪经营的几十年里,垂体手术占约翰霍普金斯手术总数的0.56%,百分比显著高于(p<0.001)在现代观察到的0.1%。丹迪的垂体临床工作与他职业生涯早期所做的重要实验研究相匹配。
结论:这项研究强调了Dandy作为促进我们对垂体疾病的病理生理学和治疗的理解的重要贡献者的作用。
BACKGROUND: Walter E. Dandy (1886-1946) was an outstanding neurosurgeon who spent his entire career at the Johns Hopkins Hospital. After graduating from medical school in 1910, he completed a research fellowship in the Hunterian laboratory with Harvey Cushing and then joined the Department of Surgery as resident, rising to the rank professor in 1931. Dandy made several contributions that helped building the neurosurgical specialty, most famously the introduction of pneumo-ventriculography to image brain lesions for which he received a Nobel prize nomination. He also performed many pituitary surgeries, although his role in this area is less known and overshadowed by that of Cushing\'s.
OBJECTIVE: This retrospective cohort study was designed to unveil Dandy\'s pituitary work and place it in the context of the overall pituitary surgeries performed at the Johns Hopkins Hospital.
METHODS: Pituitary surgery data were obtained by screening the paper and electronic surgical pathology records of the Department of Pathology, as well as the general operating room log books of the Johns Hopkins Hospital housed in the Chesney Medical Archives.
RESULTS: A total of 3211 pituitary surgeries associated with a pathological specimen were performed between February 1902 and July 2017 in 2847 patients. Most of the surgeries (2875 of 3211 89%) were done by 21 neurosurgeons. Dandy ranks 4th as number of surgeries, with 287 pituitary operations in 35 years of activity. He averaged 8 pituitary surgeries per year, a rate that positions him 6th among all Hopkins neurosurgeons. With the exception of his first operation done in July 1912 while Cushing was still at Hopkins, Dandy approached the pituitary gland transcranially, rather than transphenoidally. The majority of Dandy\'s pituitary patients had a pathological diagnosis of pituitary adenomas, followed by craniopharyngiomas and sellar cysts. In the decades Dandy operated, pituitary surgeries represented 0.56% of the total Johns Hopkins surgeries, a percentage significantly greater (p < 0.001) than the 0.1% observed in modern days. Dandy\'s pituitary clinical work was matched by important experimental studies done in the early stages of his career.
CONCLUSIONS: This study highlights the role of Dandy as an important contributor to advance our understanding of pathophysiology and treatment of pituitary diseases.