bluuebunny/crossref_metadata_2025 huggingface dataset:
Hypertension and Headache
Authors: Al. Badran R. H. , Weir R. J. , McGuiness J. B.
Published: January 2017

The incidence of headache has been assessed in 100 patients with high blood pressure and in 100 normotensive controls. Headache was more frequent in patients with diastolic blood pressures of 130 mm. Hg and over, being typically diffuse, occurring in the morning and tending to ease after a few hours. It is likely to be relieved by control of the blood pressure. No difference in incidence of headache was found between the normotensive controls and the hypertensive patients with diastolic blood pressures less than 130 mm.Hg. In hypertensive patients with occipital headache unrelieved by moderate or good blood pressure control, cervical spondylosis should be considered as a possible cause of the headache.
Ventilatory Function in Pregnancy
Authors: Cameron S. J. , Bain H. H. , Grant I. W. B.
Published: January 2017

In this investigation 60 pregnant patients underwent serial estimation of forced vital capacity (FVC) and forced expiratory volume (FEV1) throughout pregnancy and after delivery. No significant change occurred in the group mean figures of these measurements of ventilatory function. When patients were divided into those who were non-smokers and those who smoked more than 10 cigarettes daily it appeared that both FVC and FEV1 during the last 8 weeks of pregnancy were slightly reduced in the smokers.

Previous studies on the effects of pregnancy upon ventilatory function are reviewed. In this report individual patients had greater variation in both amount and direction of serial recordings than was shown by control subjects. This individual variation may have been responsible for the conflict in some earlier reports which studied smaller numbers of patients.

It is suggested that the maintenance of FEV1 and FVC during pregnancy in spite of increasing uterine size and increasing blood volume is the result of hormonal action upon the brain stem, chest wall and lung.
Acute Otitis Media in Children
Authors: Paterson Jane E. , MacLean D. W.
Published: January 2017

A group of 212 children in a partnership practice suffered from acute otitis media in the course of 1 year. These children were subjected to clinical surveillance by their general practitioners and were offered an independent follow-up examination 3 months after the onset of the illness by an otolarygologist. Their mothers were interviewed by a social worker who completed a questionnaire covering 31 items. Selected clinical findings from the general practitioner's record and from the final follow-up examination were compared with selected factors from the social study. It was found that children with less favourable social backgrounds had a poorer experience of medical supervision and poorer end results following treatment.
Computing in Radiotherapy
Authors: Orr J. S. , Cain Olive , Etchells A. H. , Halnan K. E. , Hope C. S.
Published: January 2017

An analysis of the processes of radiotherapy treatment planning is presented and explained. The application in radiotherapy in Glasgow of a variety of computers to the different parts of these processes is described under the headings: data preparation and input, software and processing, output and presentation. It has been advantageous to have specialised hardware constructed in order to simplify input. The process of computer optimisation can complete the loop formed by the comparison of the calculated and the preselected dose distributions. Nine British radiotherapy centres have joined, with Glasgow, in a co-operative group to share expertise and programmes.
Total Hip Replacement
Authors: Sillar W. , Conner A. N.
Published: January 2017

The early results of 60 total hip replacements using the Charnley Low Friction Arthroplasty are reviewed. Two patients developed severe post-operative infection. All but 3 had no pain or only slight pain which did not interfere with their activities and there was good improvement in walking function in patients with no other joint involvement. The majority of patients gained 90° of hip flexion after operation.
Prevention and Detection of Drug Taking (‘Doping’) at the IX British Commonwealth Games
Authors:   Medical Commission of the British Commonwealth Games Federation, Owen J. R. , Hill Ian , Beckett A. H. , Fraser J. , Ganeshan V. , Peterson J. N. , Smeeton W. M. , Wilson G. M.
Published: January 2017

Drugs acting on the nervous system, particularly stimulants such as amphetamine, may possibly produce a marginal improvement in athletic performance but the evidence is conflicting. They are undoubtedly dangerous to health and their use as ‘dope’ in sport is condemned. Adequate methods are now available for their detection in urine. Tests were carried out on 115 specimens taken at random from competitors in the IX British Commonwealth Games. In one, phenylpropanolamine was detected; this had been given as a therapeutic measure for relief of nasal congestion. The results were negative in all the others. The introduction of random testing at major sporting events has successfully controlled doping with stimulant drugs. The procedure was strongly welcomed by the athletes.
Ampicillin Hypersensitivity in Lymphatic Leukaemia
Authors: Cameron S. J. , Richmond J.
Published: January 2017

Skin rashes developed during ampicillin therapy in 10 of 12 patients with lymphatic leukaemia. This apparent susceptibility to ampicillin is similar to that previously described in patients with infectious mononucleosis. It is postulated that patients with lymphatic leukaemia and infectious mononucleosis have an alteration in immune response due to abnormal lymphocytic function. It is suggested that, in these patients with bacterial infection, initial antibiotic treatment should not include ampicillin.
Therapeutic Abortion: A Follow-up Study
Authors: Sclare A. B. , Geraghty B. P.
Published: January 2017

A psychiatric and psychological follow-up assessment of 21 patients accepted for abortion on psychiatric grounds, 21 patients denied abortion on psychiatric grounds and 11 patients accepted for abortion on medical grounds was carried out.

A history of prior psychiatric illness appeared to be a pointer towards therapeutic termination of pregnancy when psychiatrically disturbed pregnant women were referred for assessment. Despite a high incidence of short-lived guilt reactions, this particular group of patients generally reported a beneficial effect on their lives 2 years later.

Many, but not all, of the psychiatrically disturbed patients who were refused abortion became reconciled to the decision.

The medical group who were aborted tended to view the operation as an unfortunate necessity.

A decision for or against termination of pregnancy must take account of many factors—previous psychiatric history, present mental state, patient's attitude towards the pregnancy, marital adjustment, personality structure and medical condition
Tuberculosis in Edinburgh: B.C.G. Vaccination and Heaf Tuberculin Grades at School
Authors: Ross J. D. , Willison J. C.
Published: January 2017

Some recent findings, in respect of tuberculosis in Edinburgh, are presented and particular attention is given to the younger members of the population.

It is recognised that Heaf grade I tuberculin reactors at school may not all have been infected by tubercle bacilli, and it has been thought that some might benefit from B.C.G. vaccination.

The evidence given confirms the value of B.C.G. vaccination in the prevention of tuberculous disease in the community. Some Heaf grade I reactors have tuberculous disease, however, which is a contraindication to routine vaccination of this group.

Another contraindication is that Heaf grade I reactors, as a whole, have acquired a degree of immunity to subsequent tuberculous disease, approximating that conferred on tuberculin negative children by B.C.G. vaccination, and possibly less likely to diminish as the years progress.

Widening the scope of B.C.G. vaccination and employment of anti-tuberculosis drugs, might be advantageous and merits consideration.
Accidental Hypothermia: An Apparatus for Central Re-Warming as a First Aid Measure
Authors: Lloyd E. Ll. , Conliffe N. A. , Orgel H. , Walker P. N.
Published: January 2017

Apparatus is described which can provide a certain amount of heat for the central rewarming of a hypothermic patient. This equipment is portable and cheap and can be used by non-medical people. Examples are given of the quantities of heat involved which can amount to 30 per cent of the heat production of a hypothermic patient.
Electrophoretic Separation of Alkaline Phosphatase Isoenzymes: A Clinical Evaluation
Authors: Warwick R. R. G. , Shearman D. J. C. , Percy-Robb I. W. , Smith A. F.
Published: January 2017

In 40 patients with a raised total serum alkaline phosphatase, polyacrylamide gel electrophoresis was used to separate the liver, bone and intestinal isoenzymes of alkaline phosphatase. The method confirmed the source of the raised alkaline phosphatase in patients with established bone or liver disease. The technique was found to be more reliable than the estimation of 5'-nucleotidase activity in the detection of a raised alkaline phosphatase of hepatic origin and was also useful when the raised total alkaline phosphatase came from two sources.
Massive Digoxin Overdose: Observations on Hyperkalaemia and Plasma Digoxin Levels
Authors: Citrin D. , Stevenson I. H. , O'Malley K.
Published: January 2017

Two cases of massive digoxin overdose are described in which extremely high plasma digoxin levels were found. In both cases there was a marked hyperkalaemia and in both extreme bradycardia was successfully treated with intravenous atropine. Preliminary details of a third case are briefly reported.
Self-Poisoning
Authors: Tulloch J. A.
Published: January 2017

The experience of self-poisoning at Stracathro Hospital during 1961–70 has been reviewed. The annual incidence among adult medical admissions rose from 0.7 per cent to 3.1 per cent. It involved mainly the young, the female, the urban dweller, and a relatively high proportion of single, divorced or separated subjects, and occurred mainly at the weekends. Depression was the common associated psychiatric disorder. Suicide was intended more frequently than is noted in the cities.
Pituitary Gonadotrophic and Ovarian Function in Women Treated with Clomiphene Citrate
Authors: Adamopoulos D. A. , Loraine J. A. , Ginsburg J. , Foss G. L.
Published: January 2017

Serial estimations of follicle-stimulating hormone (FSH) and luteinising hormone (LH), as well as of oestrogens and pregnanediol have been performed in the urine of 5 women suffering from a variety of gynaecological conditions associated with infertility who were treated with clomiphene citrate at different dose levels.

One subject became pregnant following medication; in the other 4 evidence for ovulation was present in one and was at best equivocal in the remaining 3. The effect of the compound on urinary FSH and LH levels was variable as was the pattern of urinary steroid excretion following medication; in 2 subjects a rise of oestrogen output preceded that of LH excretion. The study confirms previous observations indicating that atypical luteal function may follow clomiphene administration and underlines the fact that wide variations of hormonal response to the compound can occur.
The Suppression of Involuntary Movements with Tetrabenazine
Authors: McLellan D. L.
Published: January 2017

Thirty-one patients with a variety of extrapyramidal disorders were treated with tetrabenazine in doses of 25 to 250 mg. daily for periods varying from 2 weeks to 15 months. Clinical assessment of the patients' disability before and after treatment has confirmed that tetrabenazine effectively suppresses choreiform and ballistic involuntary movements, particularly those associated with Huntington's chorea and cerebrovascular disease. Side effects were encountered frequently and a controlled study in which tetrabenazine is compared with other active drugs is now desirable.
Folic Acid and Low Birth Weight Infants
Authors: Dawson K. P.
Published: January 2017

A 2-part study was carried out to assess the degree of folate deficiency in low birth weight infants and to determine the effects of oral prophylactic folic acid in such a group. No general deficiency up to the age of 3 months was shown. The effects of folic acid prophylaxis on various parameters is described.
Beta-Thalassaemia and Some Rare Haemoglobin Variants in the Highlands of Scotland
Authors: Cook I. A. , Lehmann Hermann
Published: January 2017

A survey is described of 3968 individuals in the northern and western highlands of Scotland for haemoglobinopathies. Twenty-three abnormalities were found, involving 17 cases of beta-thalassaemia minor, 3 of Haemoglobin Koln, one man with Haemoglobin Lepore, and one case with Haemoglobin Hopkins 2. An infant with multiple birth abnormalities had a persistent high foetal haemoglobin. No examples of glucose-6-phosphate dehydrogenase deficiency of the red cells were discovered.
Fetal Maturity Assessed from Biochemical Analysis of the Liquor AMNII
Authors: MacVicar J. , Logan R. W. , Barnard W. P.
Published: January 2017

Two hundred and fifty-one samples of liquor amnii were analysed to determine the correlation between the biochemical constituents of the liquor and gestational maturity. Creatinine, oestriol and protein were the only constituents which, measured individually, correlated with maturity. The difference between the levels of creatinine in the amniotic fluid and maternal serum and the ratio of amniotic fluid to serum creatinine gave a lower percentage exact prediction than creatinine alone. Computing together all five parameters gave a prediction of gestational maturity to within 2 weeks in 73 per cent of cases. The biochemical content of the liquor amnii probably principally reflects maturation of fetal renal function, which does not necessarily correlate accurately with gestational maturity.
The Current Status of Classical Caesarean Section
Authors: Carswell William
Published: January 2017

A comparative study was made between classical and lower segment Caesarean sections between 1960 and 1971. Classical section remains inferior to lower segment section and should continue to be avoided whenever possible.
Pulmonary Thrombo-Embolism Presenting as Cardiac Emergencies
Authors: Windebank W. J. , Boyd G. , Moran F.
Published: January 2017

Pulmonary thrombo-embolism may cause symptoms and signs that are easily confused with those due to cardiac disorders. This paper describes illustrative examples from 51 patients we have studied with pulmonary embolism who were initially thought to have a cardiac illness. Seventeen presented with right heart failure, 15 had chest pain with the distribution usually associated with myocardial ischaemia or infarction, 11 had pulmonary oedema and 6 had a cardiac arrhythmia. The possible mechanisms that lead to these various cardiac presentations of pulmonary emboli are discussed.
Prediction of Fetal Lung and Kidney Maturity by Determination of Amniotic Fluid Lecithin: Sphingomyelin Ratio and Creatinine Concentration
Authors: Paton R. D. , Logan R. W. , MacVicar J.
Published: January 2017

The ratio of lecithin to sphingomyelin (L/S) in amniotic fluid was assessed in 209 patients on 275 occasions and confirmed to be a useful index of fetal lung maturity.

Although low and high ratios were found mainly at early and late gestational ages respectively, lung maturity (L/S ratio ≥ 3:1) occurred at a wide range of ages, from 28 to 40 weeks. The L/S ratio was, therefore, not found to be a useful index of gestational age in individual cases.

In 174 cases, in addition to determining the L/S ratio, the concentration of creatinine in the liquor was estimated as an index of renal maturity. (Creatinine ≥ 1.6 mg./100 ml. ≡ renal maturity). In 80 per cent of cases, lung and kidney were judged to be both mature or both immature. In the remainder, combinations of mature kidney/immature lung or immature kidney/mature lung existed. Liquor creatinine estimation remains useful as a guide to gestational age and as an adjunct to lung maturity studies.
High Dose Frusemide in Acute Reversible Intrinsic Renal Failure
Authors: Brown C. B. , Ogg C. S. , Cameron J. S. , Renal M. Bewick
Published: January 2017

Preliminary results of 19 patients with acute renal failure in a controlled trial using 3000 mg of frusemide a day are reported. These indicate that a single dose of 1 g of frusemide over four hours intravenously may completely reverse acute renal failure. Continuous frusemide infusion at a dose of 1g eight-hourly will convert oliguria into polyuria or maintain polyuria thus increasing renal nitrogenous excretion. This polyuric state allows adequate nutrition and in conjunction with dialysis helps control the uraemic state. Irreversible deafness can occur if serum frusemide levels exceed 100 μg/ml.
The Value of Ultrasonography in the Diagnosis of Abdominal Aortic Aneurysm
Authors: McGregor J. C. , Pollock J. G. , Anton H. C.
Published: January 2017

An evaluation of ultrasonography in early dilatation and aneurysm is presented. Fifty-nine patients with prominent abdominal pulsation were examined and aneurysm was demonstrated in 22. There was a high degree of correlation between the size of the aneurysm demonstrated by ultrasound and the size displayed at operation. It was also possible to demonstrate increasing dilatation by measurement on subsequent occasions.
Inhibition of Cell Proliferation in Renal Failure and its Significance to the Uraemic Syndrome: A Review
Authors: McDermott Frances T. , Galbraith Andrew J. , Corlett Russell J.
Published: January 2017

The effect of acute and chronic renal failure on cell proliferation in rapidly dividing tissues has been examined in man and animal models. The evidence reviewed supports the hypothesis that renal failure results in a general inhibition of cell proliferation. Cell population kinetic studies of gastrointestinal and skin epithelia in experimental acute renal failure show a prolongation of the cell generation cycle. Less detailed investigations of other proliferative cell systems indicate an inhibitory effect on proliferation within the generative compartment of the erythroid series, lymphoid tissue, seminiferous epithelia and wound granulation tissue. This inhibition appears partly responsible for anaemia and impaired wound healing and may contribute to the abnormal immune responses, gastrointestinal tract lesions and male sterility found in renal failure.
Assessment of Peroheme-40 for the Presence of Occult Blood in the Faeces
Authors: Krasner N. , Sumner D. , Miller S. , Thomson T. J. , Goldberg A.
Published: January 2017

Peroheme 40, a chemical test for occult blood in faeces, has been assessed by. comparing it with results obtained using 51Cr labelled red cells. The study was carried out in two parts. Initially testing was carried out on 75 stool samples from 20 patients on a restricted diet, and in the second part, testing was performed on 40 samples from 10 patients on a normal ward diet. All patients were suspected of losing blood from the gastrointestinal tract.

On the restricted diet there were 29 per cent false positive and 13 per cent false negative results, while on the normal diet, there were 86 per cent false positive and 8 per cent false negative results. Peroheme-40 has therefore been shown, on a restricted diet, to compare favourably with previously available chemical tests.
Introduction
Authors: Beaumont G.
Published: January 2017

Operational definitions and the classification of phobic and obsessional states are discussed. Suggestions are made regarding useful parameters in measuring severity and response to therapy. Avoidance is regarded as one of the central features of phobia and its value phenomenologically and clinically is emphasised. The inadequacy of the definition of agoraphobia is stressed. The division of obsessions into rituals and ruminations and the further subdivision of rituals into those of order, cleanliness and checking is considered to be a useful classification for the purposes of measurement. The distinction between bizarre and non-bizarre obsessions is discussed.
The Lynfield Obsessional/Compulsive Questionnaires
Authors: Allen J. J. , Tune G. S.
Published: January 2017

The need for adequate methods of measuring symptoms in obsessional disorders is stressed, particularly since, owing to the comparative rarity of the condition, a multicentre approach will be necessary if controlled studies are envisaged. A new method of measurement, the Lynfield Obsessional/Compulsive Questionnaire, is described. The questionnaire is derived from the Leyton Obsessional Inventory and may be of value in showing response to treatment.
Changes in Obsessive/Compulsive Patients as Measured by the Leyton Inventory before and after Treatment with Clomipramine
Authors: Allen J. J. , Rack P. H.
Published: January 2017

The Leyton Obsessional Inventory has been found to be a useful measure in assessing patients before and after treatment with clomipramine. Mean scores for symptoms and interference altered significantly during the course of treatment. The Leyton Obsessional Inventory, however, lacks external validation owing to the absence of some valid alternative quantification. In the absence of such external validation it seems justifiable to use the mean Leyton score diagnostically but not as a sole indication of severity or response to treatment.
Depressive Reactions in the Course of Clomipramine Therapy Used in the Treatment of Obsessional Conditions
Authors: Capstick N.
Published: January 2017

In a small series of patients, suffering from obsessional disorders, it was found that there seems to be a type of depression which occurs during the course of clomipramine therapy. As clomipramine is an antidepressant, this may seem to be an anomaly but it is suggested that depression is secondary to agitation and tension which are recognised side-effects of clomipramine. The patients nevertheless showed improvement in their obsessional symptomatology. The finding seems to reinforce the view that clomipramine has an antiobsessional effect which is distinct from its antidepressant property.
An Investigation into the Use of Anafranil in Phobic and Obsessional Disorders
Authors: Waxman D.
Published: January 2017

A multicentre clinical trial of clomipramine in the treatment of obsessional and phobic disorders in general practice is described. All phobias showed an improvement in situational anxiety, interference and autonomic side effects. With the exception of two cases of animal phobia there was also improvement in general anxiety and avoidance. Obsessional cases showed an overall improvement in all symptom areas.
Body Infestations
Authors: Morley W. N.
Published: January 2017

The common body infestations, their incidence, diagnosis and treatment are discussed. Pediculosis capitis still has a high incidence in Britain. The louse could probably be effectively eradicated provided a national campaign of treatment and education were undertaken. Intensive therapy with a malathion containing preparation should be used before the louse develops resistance to this new organophosphorus insecticide. Similarly, scabies can be effectively treated. All doctors should be aware of the signs and symptoms of this common dermatosis and its treatment.
Enzymic Activities of Commercial Preparations of Pancreatic Enzymes
Authors: Drummond Sheena , Saunders J. H. B. , Leach R. , Wormsley K. G.
Published: January 2017

The enzymic activities of 20 commercial pancreatic extracts have been measured by standard (F.I.P.) methods of assay and the activities have been compared with a standard preparation of pancreatin supplied by the British Pharmacopoeia Commission. A wide range of enzymic activities was found. The tabulated cost per unit of enzymic activities provides a guide to one aspect of the potential therapeutic efficacy of pancreatic extracts in the treatment of pancreatic exocrine insufficiency.
The Use of Erythromycin in a General Practice
Authors: Grob Paul R.
Published: January 2017

It would appear that erythromycin is a safe drug to use in general practice; it is indicated, and has advantages, in the treatment of infections of both the upper and lower respiratory tracts.
The Therapeutic Efficacy of Electroconvulsive Therapy (Ect) a Double Blind Controlled Trial of Ect and Simulated Ect
Authors: Freeman C. P.
Published: January 2017

A double-blind controlled trial of ECT versus simulated ECT is described. The results show that real ECT is significantly superior to simulated ECT in the treatment of depressive illness.
Indications for the use of Tranylcypromine and Trifluoperazine: (Parstelin)
Authors: Lyons H. A. , Degerli M.
Published: January 2017

Thirty-two patients were treated with the combination of tranylcypromine and trifluoperazine (Parstelin). The patients fell into 3 clinical groups, namely, endogenous depression (7 patients), neurotic depressive reaction (10 patients) and phobic anxiety with some depressive features (15 patients). Satisfactory response was found in 10 out of the 15 patients with phobic symptoms. The response in the other 2 groups was not significant. Side effects were troublesome in the neurotic depressive reaction group. In the phobic group the symptoms of the patients who responded were inclined to recur when the treatment was discontinued. It is considered that it is a useful preparation in the treatment of some phobic patients, but one must expect that the patients are likely to have to remain on the drug for long periods of time.
Cold Lymphocytotoxins in Connective Tissue Disorders
Authors: Browning J. D. , Dick Heather M. , Sturrock R. , Grennan D. , Dick W. C.
Published: January 2017

Sixty-eight patients with various connective tissue disorders, 5 relatives of patients and 26 members of staff from the Centre for Rheumatic Diseases were studied for the presence in their sera of cold lymphocytotoxic antibodies. Antibodies were found in 71 per cent of patients with systemic lupus erythematosus, 27 per cent of patients with rheumatoid arthritis, 0 per cent of the small group of relatives and 3.8 per cent of the controls. Absorption studies did not show T or B specificity of the antibodies. The control group, working in close proximity to the patients or their sera did not show any increased incidence of antibodies as compared to control groups of other studies. Red blood cell anti I or HI was found in the sera of 28 per cent of those with cold lymphocytotoxic antibodies. No correlation was found between the presence of the antibodies and number of blood transfusions or pregnancies, increasing age, R 3 titre or antinuclear factor.
Amyloidosis in Hodgkin's Disease: A Scottish Survey
Authors: Champion M. , Richards R. L.
Published: January 2017

Hodgkin's disease is a rare cause of secondary amyloidosis. In Scotland in the period 1961 to 1974 four patients in whom these 2 conditions were associated have been identified. In one of these the presence of amyloidosis was an unexpected finding at a staging laparotomy for Hodgkin's disease. The clinical and pathological features are summarised. The development of amyloid disease is usually suspected by the finding of proteinuria, which is rarely present in uncomplicated Hodgkin's disease. A distinction is made between a nephrotic syndrome due to glomerulopathy, which is an early complication of Hodgkin's disease and improves with treatment of the primary condition, and the nephrotic syndrome due to amyloidosis which occurs late in the course of the illness and is irreversible and rapidly progressive.
Medical Treatment of Breast Cancer
Authors: Stoll B. A.
Published: January 2017

Medical treatment is potentially more important than surgical treatment for the large majority of patients presenting with breast cancer. Since each patient has unique characteristics affecting both tumour aggressiveness and host defence, a generalised approach to medical treatment is no longer acceptable.
Infection and Immunization
Authors: Stewart G. T.
Published: January 2017

Herd infections, especially in children, are strongly influenced epidemiologically by social and demographic factors which have contributed favourably to a general decline in incidence and mortality during the past 50 years or more. Intervention procedures such as immunization cannot be evaluated or planned realistically except against these background factors.

Assessed in this way, immunization against diphtheria and poliomyelitis was unequivocally effective in reducing incidence and morbidity of these diseases. By comparison, pertussis vaccine has a very limited protective effect, the value of which, as morbidity decreases, may be offset by the intrinsic toxicity of the vaccine and by the possibility of infrequent but severe brain damage in some children.
Electroencephalography—Use and Abuse
Authors: McGeorge Anne P. , Durward W. F.
Published: January 2017

The E.E.G. is a reliable, safe and readily available test, especially for screening purposes in hospitals where brain scan and EMI scan facilities are not available. Its reliability becomes less when unreasonable demands are made regarding the nature of pathology, precise localisation and extent of a lesion. A detailed clinical history is mandatory for the neurophysiologist to make a useful interpretation of the E.E.G.
Cystic Fibrosis in Adolescents and Young Adults
Authors: Howie A. D. , Stack B. H. R.
Published: January 2017

With the early diagnosis of cystic fibrosis and the better management of these patients in childhood increasing numbers are surviving to adult life. The main problem requiring continuous medical care in the older cystic fibrosis patient is persisting and often progressive chest disease. For this reason the cystic fibrosis clinic for adolescents and young adults was started in the Western Infirmary in 1975. This paper presents our observations on 13 patients who have attended between 1975 and 1977. Eleven patients are alive and well and have shown no evidence of deterioration over this period. Ten are at school or in regular employment. With optimum medical supervision it is possible to give young adults with cystic fibrosis a worthwhile existence.
A Study of Patients with Abdominal Symptoms of Undefined Cause
Authors: Bouchier I. A. D. , Mason Christine M.
Published: January 2017

This paper describes the results obtained from a study of 14 patients with symptoms of abdominal pain, nausea and vomiting which had continued for considerable periods of time and which, despite extensive investigation, eluded diagnosis.

The study sought to examine the characteristics of patients who continue to suffer these symptoms and to identify their social and psychological effects. It was found that this symptom complex disrupted roles and activities in a manner out of proportion with clinical seriousness.

Results from this preliminary investigation seem to point in the direction of two distinguishable groups of patients in whom the emergence and prognosis of symptoms are different. In one group, symptoms appear to be precipitated and exacerbated by problems within the environment and which disappear when such problems are ameliorated; in the other group symptoms appear as part of a long-term psychiatric illness. Implications for management are discussed.
Post-Operative Analgesia following Laparoscopic Sterilization
Authors: Leggat I. T. , Barr W.
Published: January 2017

In a retrospective survey of 161 consecutive cases of laparoscopic sterilization performed over a period of six months, 41.6 per cent were by tubal diathermy and 58.4 per cent by silastic Falope ring application. It was found that, in the latter group 28.7 per cent of patients required major post-operative analgesia, while in the group treated by diathermy only 4.5 per cent required such sedation.
Medical Care for the Homeless-Some Experience in Glasgow
Authors: MacIntyre D.
Published: January 2017

The experience of running a medical clinic using voluntary help for the homeless is described. As a group they have limited access to normal medical channels despite high morbidity. In particular psychiatric illness, most frequently related to alcohol abuse, infestation, respiratory disease and problems due to poor foot care present commonly. No major administrative problems were encountered. The effects of such special arrangements for the homeless are assessed.
Clinical and Metabolic Features of Overdosage with Amesec
Authors: Adam R. D. , Robertson C. , Jarvie D. R. , Stewart M. J. , Proudfoot A. T.
Published: January 2017

A 23-year-old woman ingested 2g. amylobarbitone, 10.4g. aminophylline and 2g. ephedrine. She was deeply unconscious, hypothermic, and went on to have supraventricular and ventricular dysrhythmias, convulsions and haematemesis. During the last convulsion she aspirated vomitus and died. The peak plasma concentration of amylobarbitone was 19mg. per l. and those of ephedrine and theophylline were 13 times higher than accepted therapeutic levels. During the course of the poisoning marked hypokalaemia (1.8mmol./l.) and hyperinsulinaemia (>240mU./l.) were found in conjunction with mild hyperglycaemia (9.6mmol./l.) and elevation of free fatty acid levels (1860μmol./l.). The mechanism of these changes is discussed.
The Role of the Lymphocyte in Haemopoiesis
Authors: Barr Ronald D.
Published: January 2017

According to current dogma, circulating blood cells are all derived from the same progenitor, which therefore must be both pluripotent and capable of prolific self-replication. In the irradiated mouse, such haemopoietic stem cells (HSC) give rise to splenic colonies, and thus are designated as CFU-S (colony forming units-spleen). Definitive identification of a similar entity in man so far has proved elusive. However, primitive unipotent cells, committed to development along a single pathway, can be detected in human blood-forming tissues under appropriate culture conditions. Operationally defined as CFU-E (erythrocyte), CFU-GM (granulocyte/macrophage) etc., the ontogenetic relationships of these cells to each other and to the HSC have been the objects of exhaustive study. A population of lymphocytes, classed as ‘null’ cells, do not exhibit the surface membrane markers which characterize commitment to differentiation in the thymusdependent (T-cell) or bursa- equivalent (B cell) lineages. Accumulating evidence points to the null lymphocyte as a potential precursor of haemopoietic tissue. In bone marrow, the activity of terminal deoxynucleotidyl transferase (TdT) is concentrated in null cells, but the relevance of this unique enzyme to lymphocytic differentiation remains uncertain. Nevertheless, it appears that the functional heterogeneity, expressed within the family of lymphocytes, extends to haemopoiesis. The roles of various lymphocyte populations, in the generation and functional control of blood-forming tissue, are examined in this review.
Circannual Rhythm of Arterial and Venous Thromboembolic Disease
Authors: Entrican J. H. , Douglas A. S.
Published: January 2017

This study confirms previous reports of a seasonal variation in morbidity and mortality from coronary and cerebral arterial disease; these disorders are much less common in summer (e.g. July and August) than in winter (e.g. December and January). In coronary disease the shape of the curve for the annual morbidity is different from that for annual mortality and possible reasons for this are discussed. A similar circannual rhythm has been shown for venous thrombo-embolic disease.
Acute Lead Poisoning: An Unusual Cause of Hepatitis
Authors: Beattie A. D. , Mullin P. J. , Baxter R. H. , Moore M. R.
Published: January 2017

Four patients, aged 17 to 25 years, obtained lead and opium pills which had been stolen from retail pharmacists. They crushed them, suspended them in water and injected them intravenously. They developed general malaise, vomiting and constipation, and blood tests several weeks after injection of the pills showed raised alkaline phosphatase and aspartate transaminases. All four patients had negative tests for the hepatitis B surface antigen. Liver biopsy specimens showed persistent hepatitis in one and resolving hepatitis in the remaining three. Liver lead levels were grossly elevated in every case.

The liver lead levels found in the patients described here were up to 35 times greater than levels which have been reported in industrial lead poisoning. It is postulated that the livers of patients with chronic lead poisoning are able to withstand this insult whereas in the cases described the overwhelming dose of lead was sufficient to cause hepatic damage.
Book Review: Paraneoplasia. Biological Signs in the Diagnosis of Cancer
Authors: MACKay N.
Published: January 2017

Paraneoplasia. Biological Signs in the Diagnosis of Cancer, by Jan G. Waldenstrom. John Wiley & Sons Inc. 1978, pp 139. £14.00.
Phagocytic Cells in the Human Inflammatory Response
Authors: Raeburn J. A. , van Zwet Theda , Leijh P. C. J. , van Furth R.
Published: January 2017

Human phagocytic cells are of crucial importance in the early responses to infection. However, tests of their function have been somewhat neglected in immunological screening. This paper summarises briefly our techniques for studying neutrophils and monocytes in skin abrasions and a simple assay of phagocytic and bactericidal function. These techniques use small volumes of blood and are suitable for inclusion in the early screening of individuals who have repeated bacterial infections.
Somatomedins and other Serum Growth Factors
Authors: Cohen H. N. , Fyffe J. A.
Published: January 2017

Growth hormone is essential for sustaining longitudinal growth in man. However, during the last 20 years, it has become evident that the actions of growth hormone, at a cellular level, are mediated by specific growth promoting factors.

This paper describes the nature and actions of mammalian growth factors and summarises the immense contribution that the measurement of these substances has made towards the elucidation of many problems in the science of human growth and development.
The Early Diagnosis of Multiple Sclerosis
Authors: Ashworth B.
Published: January 2017

An outline of modern views on the aetiology of multiple sclerosis is followed by a discussion of diagnosis. Examination of the cerebrospinal fluid, visual evoked potentials, and other electrophysiological tests are considered. The special problems of optic neuritis, spastic paraparesis, and psychological disorder receive more detailed attention. It is concluded that while the supplementary tests are valuable the diagnosis remains essentially clinical.
Academic Departments of General Practice in Ontario and Scotland
Authors: Hannay D. R.
Published: January 2017

The departments of family medicine in Ontario are compared with departments of general practice in Scotland. The former are mainly involved with postgraduate training and are much larger than the Scottish departments which are primarily concerned with undergraduate teaching. Because of the difference in numbers the full time staff in the Department of Family Medicine at McMaster University were compared with those in all four Departments of General Practice in Scotland. A self completed questionnaire was used to find out where the full-time academic staff had come from; what they were doing at present; and where they saw themselves and academic family medicine going in the future. The results are discussed in the context of health care provision and medical education in Canada and the United Kingdom.
Hereditary Angio-Oedema: Its Pathogenesis and Management
Authors: Ballogh Z. , Whaley K.
Published: January 2017

Hereditary angio-oedema is a genetically-determined disease. Usually the disease is due to a deficiency of CĪ inhibitor or less commonly to the production of a functionally inactive molecule. The pathogenesis and clinical features of the disease are reviewed, and discussed in relation to the homeostatic role of CĪ inhibitor. Finally the therapeutic approach to the disease is described and the scientific bases for the newer therapeutic regimes discussed.
The Pattison-Miller Quarrel
Authors: Pattison F. L. M.
Published: January 2017

An account is given of a bitter quarrel in 1817 between two of the attending surgeons at the Glasgow Royal Infirmary. The protagonists were Granville Sharp Pattison and Hugh Miller, the latter accusing the former of unprofessional conduct in the performance of two amputations. A Committee of Enquiry was set up; Pattison was found to have been at fault in one of the operations, and was censured by the Infirmary's Board of Directors. The fracas has been reconstructed from two original hand-written documents: the Proceedings of the Committee of Enquiry and Pattison's Memorial of Exculpation.
Carcinoid Tumour of the Oesophagus: Report of a Case
Authors: Rankin R. , Nirodi N. S. , Browne M. K.
Published: January 2017

A case of carcinoid tumour of the oesophagus in a 54-year-old man is described and the literature is briefly reviewed. This is the third reported case in the world literature and the rarity of the disease is emphasised.
Renal Transplantation—A Tale of Two Cities
Authors: Wood R. F. M. , Bell P. R. F. , Walls J. , Nash J. R. , MacPherson D. S. , Reilly D. T. , Briggs J. D. , Dick Heather H.
Published: January 2017

In 1974 three members of the transplant team from the Western Infirmary in Glasgow moved to the new medical school in Leicester. The initial experience with 33 patients transplanted in Glasgow was published in 1972 and this paper compares the results of that series with the first 21 patients grafted in Leicester.

Despite improvements in tissue typing, better quality donor kidneys and fewer complications, there has been a failure to improve on the levels of graft survival. The overall one year graft survival rate in the Glasgow series was 79 per cent compared to 52 per cent in Leicester. In these two series the difference in results appears to be explained by blood transfusion. All the Glasgow patients had been poly-transfused but of the Leicester patients the 10 transfused pre-transplant had a one year graft survival of 90 per cent while in the 11 non-transfused patients the one year graft survival was only 18 per cent.
The Clinical Significance of the Antinuclear Antibody Test as a Screening Procedure for DNA Antibodies in SLE
Authors: El-Ghobarey A. E. , Sloane D. J. P. , Whaley K.
Published: January 2017

During the two-year period (1st October 1974–30th September 1976), 2979 sera were tested for DNA antibodies by the Farr test. One thousand six hundred and ninety-five of these were tested because they had high ANA titres (1/256 or greater). In this group 285 sera were found to have raised DNA binding capacities (DNA-bc), 86 of which were found in patients having diagnoses other than SLE. When the diagnoses were reviewed following the finding of a raised DNA-bc, 55 of these patients were found to be suffering from SLE. Of the 1284 sera tested for DNA antibodies without the prior ANA screening procedures, 288 were positive, 36 of which came from patients not considered to have SLE; 30 of these patients were subsequently shown to have SLE. Thus the DNA-bc test is an important tool in the diagnos is of SLE, and the ANA test appears to be a valuable screening procedure. The level of DNA-bc was not of any diagnostic value.
Successful Triplet Pregnancy following Renal Transplantation
Authors: MacLean A. B. , Sharp F. , Briggs J. D. , MacPherson S. G.
Published: January 2017

There are now many reported successful pregnancies to renal transplant recipients, but this is believed to be the first reported successful case of triplets. The clinical course, complications and management of the pregnancy are described.
A Novel Gaba Receptor on Central Neurones
Authors: Bowery N. G. , Doble A. , Hill D. R. , Hudson A. L. , Shaw J. , Turnbull M. J.
Published: January 2017

The features of γ-aminobutyric acid (GABA) as an inhibitory neurotransmitter are described, together with those of its receptor as defined by both iontophoretic and radiolabelled ligand binding techniques. Evidence is presented supporting the existence of a second GABA receptor at both peripheral nerve endings and within the CNS. At the classical receptor, GABA can produce a depolarisation of the ganglion cell body or mediate hyperpolarisation within the CNS by increasing membrane conductance to chloride ions. At this second receptor GABA acts in a bicuculline-insensitive manner to reduce neurotransmitter outflow.

Many GABA analogues active at the classical receptor are inactive at the second receptor but by contrast baclofen which is inactive at the classical receptor is a potent agonist at the novel site.
Baclofen as a Potential Analgesic Agent
Authors: Cutting Derrick A. , Jordan Christopher C.
Published: January 2017

It is proposed that analgesia might be achieved by pharmacological interruption of sensory input to the C.N.S. at the level of the spinal cord. On the basis of early reports that baclofen mimicked presynaptic inhibitory mechanisms in the spinal cord, baclofen was tested for potential analgesic activity in the mouse hot-plate test. Baclofen appeared to have some antinocisponsive activity in its own right and it potentiated the antinocisponsive effect of morphine. This observation has been confirmed and extended by several authors and the antinocisponsive activity appears to reside in the 1-isomer. Both spinal and supraspinal sites have been suggested for the locus of action in the C.N.S., whilst the underlying cellular mechanism may be inhibition of neurotransmitter release (via a bicuculline-refractory GABA receptor) or antagonism of the post-synaptic actions of substance P as a neurotransmitter.

Baclofen is compared with two other antinocisponsive agents (morphine and clonidine) in terms of its effects on release of neurotransmitters. Consideration is given to the possibility that a further characteristic is shared by these compounds, namely that following chronic administration, abrupt cessation of therapy might be accompanied by withdrawal or ‘rebound’ effects.
Clinical Experience in the use of Baclofen in Children with Spastic Cerebral Palsy: A Further Report
Authors: Young J. A.
Published: January 2017

The results of an open trial of baclofen in children with spastic cerebral palsy are presented. In intelligent children with pure spastic diplegia there was improvement in mobility and in ability to wear orthoses. In more severely affected children the benefit lies in the possibility of preventing postural deformities, in allowing increased participation in physical therapy and in facilitating nursing care. The reduction in tone is most useful when it allows the child or his therapist to do something that had been prevented by spasticity. The drug seems to be of little value in mixed types of cerebral palsy and of no value at all in children with fixed deformities. A suitable starting dose is 5 mg twice or thrice daily increasing over two weeks to a total of 2− 2.5 mg/kg/day.

Sedation and hypotonia were occasionally seen but could be controlled by adjusting the dose. Control of epilepsy did not deteriorate.