Professor Robert Carachi
SMJ 2006 51(1): 4-7
As Editor of the Scottish Medical Journal, I am proud to present the Jubilee Issue to all our readers. The Scottish Medical Journal is celebrating its 50th year and it looks better than ever. Just over a year ago we planned this edition and the new look and the contents have involved a considerable amount of work by the Editorial Team.
Editorial Team
My secretary, Kay Byrne, is assisted now by Jennifer Layden who co-ordinates the manuscripts and sends them out for peerreviewing. They have compiled a large database of all manuscripts and peer reviewers which will speed up the process and make it more efficient.
Assistant Editor
Due to the increased workload an Assistant Editor, Jill Murie, has joined us. I am delighted to welcome her on to the Editorial Team. Her role as Assistant Editor will be to offer support and introduce new ideas in the Scottish Medical Journal as well as help me with the increasing workload of manuscripts that are daily coming for peer reviewing. “I have been a GP principal and forensic physician in Lanark since 1985, during which time I have developed a strong public health perspective and interest in clinical governance. Working with SNAP, SIGN and RCGP (Scotland) I have contributed to national reports and published papers on health promotion, health needs assessment, risk management, guideline implementation, audit and patient and public involvement. As an Appraiser and Associate Adviser with NHS Education for Scotland, I aim to raise standards in primary care by creating a learning culture within general practice and changing GPs from passive recipients to active participants in education. I am delighted to have been appointed Assistant Editor of the Scottish Medical Journal. I hope that this will give me the opportunity to promote the SMJ as the flagship journal of the Royal College of Physicians and Surgeons of Glasgow recognising the contribution and quality of education, research and best practice in health care systems in Scotland and internationally.”
Dr Jill Murie, MB ChB, MPH, DRCOG, DFM, FRCGP
Sub Editors
History
Three new Sub-Editors have been commissioned by the Board. David Hamilton is Sub-Editor for the History Section. One of the strengths of the Scottish Medical Journal is its history which is important for us to document and for readers to enjoy reading about the illustrious figures of the past who have fashioned our future. David is certainly the right man for this job. He is now responsible for the historical articles that come to the Journal.
Education
Two other Sub-Editors whom we have co-opted are Sub- Editors for the Educational Section of the Journal. Graham Sunderland is the Sub-Editor for the Surgical Section of the Journal and David Bilsland is the Sub-Editor for the Medical Section of the Journal. In this section of the new Scottish Medical Journal, it will be the responsibility of this team to commission educational articles and ensure that they are of a high standard for our readers. We are grateful to Mr. Ian Finlay for his contribution on colorectal cancer I look forward to seeing how this Section of the Journal is going to develop with the support of the College. The College will also be announcing its forthcoming events and meetings in this Section.
Production Team
We also have a new Production Team who are involved in the layout of the Journal illustrating it and delivering the final product to the reader. The Production Team includes James Beaton, College Librarian and Anne Hanlon-Bucher, Graphic Designer, both at the Royal College of Physicians and Surgeons of Glasgow.
Webpage publishing (www.smj.org.uk)
“The Scottish Medical Journal has been on the Internet since 2000 and has been there in full text since 2002. Personally it has been an interesting experience as it was my first foray into website publishing. Medical journal publishing on the web is an interesting area and I am sure it is causing a great deal of debate amongst both editors and publishers. Is it the future of publishing? It is certainly a cheap way of publishing. Webspace, together with a webpage construction and file transfer program costs only a small fraction of the cost of publishing on paper and can reach a much wider audience. Over the last decade there has been an explosion of confidence in the dotcom businesses followed by the collapse of many such businesses which bought into the new way of working. Despite this hesitant start, my personal view is that over the next few years, scientific websites will take over from paper publishing. Is there any evidence to back this up? There is some hard data which supports this. When the SMJ website was first published in 2000 there were several hundred ‘hits’ per month. In the latter part of 2005 this has increased to approximately 10000 per week. This may be related to better advertising, with the Journal now easy to find on Google and other search engines. It may indeed be a reflection of better quality and more interesting articles although I do not think that this is the reason. My main reason for the conclusion that the web will take over from paper publishing is my reflecting both on how my practice has changed in the last 5 years, and observation of my colleagues. There is a greater access to computers, the internet and, thanks to organisations like the national e-library (www.elib.scot.nhs.uk), to full text articles. I know that this is only level 4 evidence for the demise of paper publishing, but time will tell.”
Collaboration of the Scottish Medical Journal with the College
The Scottish Medical Journal is entering a new era of collaboration with the College and it is now in a stronger position than ever to become the main Journal for Scotland and indeed for all the Members and Fellows of the College. For the first time, the circulation has been increased to 15,000 copies which will be distributed to all Members and Fellows worldwide and also to the main educational and caring institutions in Scotland. The Medical Schools are also included in this circulation to try and encourage medical students to read the Journal and contribute to it. We have also a large number of peer-reviewers who have offered their services as a result of the recent advertising through the President’s Newsletter.
Honours
We would like to congratulate Professor Sir Graham Teasdale, the President of the Royal College of Physicians and Surgeons of Glasgow, who was awarded a Knighthood for services to neurosurgery. Together with Professor Brian Jennett they developed the Glasgow Coma Scale (GCS) a universally recognised scale of consciousness in the coma patient. We are very grateful for the support of the President and the College.
Obituary
On a sadder note we would like to report the sudden death of Professor Watson Buchanan. I have asked Roger Sturrock, a close friend of his, to write an obituary. It is fitting that we should include the obituary of Professor Watson Buchanan whom I got to know only recently through telephone conversations to Canada with him about his article. We commissioned an article from him towards the end of last year and he delivered it on time and I would think that this is probably the last article he wrote before he died. We would like to commemorate his memory and honour him as well in this issue.
In memoriam
“Watson Buchanan graduated from the University of Glasgow in 1954 when as a medical student, he won the McFarlane Prize in Medicine. His early clinical interest was in endocrinology and he worked with Professor Sir Edward Wayne at the Western Infirmary where he undertook some research on autoimmune thyroiditis which was the subject of his MD thesis. He subsequently travelled to the NIH in the United States where he worked closely with Dr. Joseph Bunim and undertook some research on Sjögren’s syndrome which resulted in the publication of a seminal paper on the clinical characteristics of this condition. Watson returned to Glasgow in 1964 as a Senior Lecturer in the University Department of Medicine and was instrumental in setting up a rheumatology unit within a small hospital in Baird Street that became known as the Centre for Rheumatic Diseases. Together with Dr. Tony Boyle, Dr. Wilson Downie and subsequently Dr. Carson Dick he put Rheumatology on the map in Glasgow and developed a centre of excellence for Clinical Rheumatology which rapidly gained a national and international reputation. He was appointed a Titular Professor within the University of Glasgow in recognition of his clinical research and teaching in rheumatic diseases. In 1979 he was attracted to McMaster University in Hamilton, Canada where he remained as a Clinical Professor of Rheumatology until his retirement. Watson Buchanan was a larger than life character who had the capacity to enthuse all who worked with him. He had tremendous energy and a broad interest in many aspects of clinical rheumatology. He was particularly interested in the clinical pharmacology of non-steroidal anti-inflammatory drugs and also in the clinical assessment of inflammatory joint disease. Together with an Occupational Therapist, Dorothy Ritchie, he developed the Ritchie Articular Index which was the forerunner of modern joint assessment indices and the original publication of the Ritchie Index is still one of the most cited papers in Rheumatology today. Watson attracted a large number of doctors, both from home and from overseas who wished to train in Rheumatology at the Centre for Rheumatic Diseases. He was an excellent teacher and mentor and many of his junior staff went on to hold senior positions in Rheumatology and Medicine, both within the UK and abroad. Watson loved debate and argument. He was a master of hyperbole but always with a sense of “tongue in cheek”. He had a keen interest in Scottish history and in the history of medicine and published papers in both of these subjects. In 2004 Watson was awarded the Cullen Prize from the Royal College of Physicians of Edinburgh in recognition of his clinical and academic excellence and the greatest benefit done to practical medicine. He was truly a giant in Rheumatology and we are all diminished by his passing at the age of 75, following a short illness. He is survived by his wife, Margaret, and his three children, Helen, James and Allan.”
Roger D Sturrock McLeod/ARC Professor of Rheumatology, University of Glasgow.
The scientific contribution of the Scottish Medical Journal to medicine over the years
I have selected four articles to highlight the immense contribution of the Scottish Medical Journal to medicine over the years. Indeed, David Hamilton has done a service detailing the history of the Scottish Medical Journal in one of the commissioned articles in this Jubilee Issue. The four articles I have chosen are as follows:
Several patients from a further series of cases of congenital obstructions of the pylorus treated by operation by JH Nicoll, Glasgow Medical Journal, 1906: 65: 253-7 (The Glasgow Medical Journal was a predecessor of the Scottish Medical Journal).
In this seminal paper Nicoll, the Father of Day Surgery (see History Section in this issue) reported on his operation for babies with pyloric stenosis. He presented a series of several patients that had been successfully treated by this operation. He first published his original operation in the British Medical Journal on 1st September 1900 where his case was probably the first successful case of operation for this affliction (Ramstead’s operation for pyloric stenosis was published in 1912).
Myasthenia gravis: a new hypothesis by John Simpson, Volume 5, October 1960 Number 10.
“This classic 1960 paper by J A Simpson, who, was my distinguished predecessor at the Glasgow University Neurology Department, is one of the most brilliantly insightful and prophetic in the history of Neurology. The paper, which to date has received 548 citations, concerns the pathogenesis of the neuromuscular disease Myasthenia Gravis (MG), a serious neuromuscular disorder usually causing generalised fatiguable weakness which can be fatal if untreated because of its adverse effects on respiratory function. At the time of writing the clinical and natural history of MG were well-known, but its cause was undiscovered. In the first part of the paper, Simpson analysed the clinical features of 440 MG cases examined personally and of the literature. He drew attention to the fact that MG was sometimes associated with diseases thought to have an autoimmune basis such as rheumatoid arthritis, diffuse lupus erythematosis, and thyroid disorders. He therefore reasoned that MG might also have an autoimmune basis. The next intellectual step was to hypothesise what kind of immunopathological mechanism might be operating in the disease to produce its characteristic disorder of neuromuscular transmission. To do this, he first considered the relevance of the lymphocytic infiltrations in the thymus gland that may occur in MG, and then analysed logically the different types of process that would be capable of producing the typical electrophysiological features that result in MG symptoms. After considering the various logical possibilities, he suggested that the most likely cause was an antibody circulating in patients that was capable of competitively blocking neuromuscular transmission by occupying receptor sites on the muscle end-plate. He therefore concluded that MG could be an autoimmune disease in which an antibody to end plate protein was formed.
It was not until 13 years later that this hypothesis was proven in an experimental animal model of MG, following which studies in patients revealed that the majority had a serum antibody directed against the acetylcholine receptor on the motor end plate which was the cause of the failure of neuromuscular transmission, just as Simpson had predicted. Removal of these antibodies using plasmapheresis could result in marked improvement in the patient’s symptoms. These facts are, of course, now very well established and part of routine neurological practice both in terms of diagnosis and treatment. But for Simpson to have been so right in 1960 is truly impressive, especially when one reads the article in detail now with the full benefit of hindsight. To have correctly deduced that the disease was autoimmune was important enough. But to have then proceeded to predict, correctly, the identities of both the antibody and the target antigen involved, was an intellectual achievement of truly astonishing proportion. It is a tribute to the Scottish Medical Journal that it had the prescience to publish his paper.”
Commentary by Peter GE Kennedy, MD, PhD, DSc, FRSE, FMedSci, Burton Chair of Neurology, Head of Division of Clinical Neurosciences, University of Glasgow
Management of myocardial infarction: the effect of early mobilisation by B.M. Groden, A. Allison, GB Shaw. Scottish Medical Journal 1967: 12: 435-440
Subsequent to the publishing of this paper, early mobilisation became established in the UK and throughout the world, leading to very significant benefits to patients, the NHS and the cost of medical care for coronary patients.
Genito-urinary tuberculosis in Glasgow 1970 to 1979: a review of 230 patients B.G. Ferrie and J.S.H. Rundle, Scottish Medical Journal 1985: 30: 30-34
This paper highlighted the steady incidence of 20 cases per year of genito-urinary tuberculosis.
Mission Statement
The Scottish Medical Journal, having reached its 50th year, is now on the threshold of an exciting new era in medical publishing. In this modern era of electronic publishing the hard copy coloured printed version is still as popular as ever and will continue to be so. The aims of the Editor are that it is the voice of the educationalist to help in the training of undergraduate and postgraduate medical and dental students and others in the caring profession. To be the voice for the scientist to publish original articles and disseminate their knowledge to all the readers of the Journal. To have a political voice to discuss issues to do with the health care of the nation and other global issues that affect mankind. To be the voice of the historian to remind us about the people and the events that allow us to practice medicine to the highest possible standard and to enable us to deliver the best care to our patients. We must acknowledge our reviewers of the many articles and the contributors who have been commissioned to write articles as well as submit original scientific articles and audits to the Journal.
