bluuebunny/crossref_metadata_2025 huggingface dataset:
Visual Acuity and Retinal Changes in South Australian Aborigines
Authors: Edwards F. M. , Wise P. H. , Craig R. J. , Thomas D. W. , Murchland J. B.
Published: March 2008

Summary: Visual acuity and retinal changes in South Australian Aborigines. F. M. Edwards, P. H. Wise, R. J. Craig, D. W. Thomas and J. B. Murchland

Eye examinations were carried out at four Aboriginal reserves. Of 361 Aboriginal adults tested, 64 had a visual defect (visual acuity of 6/9 or worse) in each eye, a prevalence of 18%, with an additional 79 (22%) with a similar loss of acuity in one eye only; these were more frequently seen at the urbanized reserve of Koonibba.

Only one full blood Aboriginal child within the less urbanized communities had a reduced visual acuity, whereas seven (10%) part blood children at a more urbanized reserve had reduced vision in both eyes, with a further nine (13%) in one eye only, not unlike figures quoted for South Australian school children.

Vascular changes in the fundus oculi were observed and occurred more often when hypertension and/or hyperglycaemia were present. They consisted of arteriovenous crossing changes (26%), swelling of the retinal veins (3%) and altered light reflex (41%) and were not infrequently seen in the younger adult (20% of adults under 30 years had AV crossing changes and 46% had widened light streak). Analysis suggests that, although hypertension and hyperglycaemia are related to retinal vascular changes, other factors, as yet unidentified, are present in the Aboriginal population under consideration.
Calcium Metabolism after Renal Transplantation
Authors: Duggin G. G. , Dale Nancy E. , Johnson J. R. , Evans R. A. , Whittlestone Anne L. , Tiller D. J.
Published: March 2008

Summary: Calcium metabolism after renal transplantation. G. G. Duggin, Nancy E. Dale, J. R. Johnson. R. A. Evans, Anne L. Whittlestone and D. J. Tiller

Calcium metabolism was studied in four patients who had undergone renal transplantation from eight to 19 months previously. The studies included conventional biochemical and radiological parameters, undecalcified bone histology and metabolic balances. The only abnormality found was biochemical and histologic evidence of mild hyperparathyroidism. All patients were in approximate calcium balance, and there was no evidence of osteoporosis, osteomalacia or osteitis fibrosa. It is suggested that transplantation patients with stable, well functioning grafts and normal biochemical and radiologic parameters are unlikely to have or to be at risk of developing metabolic bone disease.
Lithium Associated Thyroid Disease—A Report of 14 Cases of Hypothyroidism and 4 Cases of Thyrotoxicosis
Authors: Brownlie B. E. W. , Chambers S. T. , Sadler W. A. , Donald R. A.
Published: March 2008

Summary: Lithium associated thyroid disease—A report of 14 cases of hypothyroidism and four cases of thyrotoxicosis. B. E. W. Brownlie, S. T. Chambers, W. A. Sadler and R. A. Donald

Thyroid function was assessed in 80 patients receiving long‐term lithium therapy. Three of the 80 patients were biochemically hypothyroid and a further patient was receiving thyroxine for lithium associated hypothyroidism. A further eight patients had elevated TSH levels and eight patients had subnormal serum triiodothyronine levels. After a 24 month follow up period seven of the 80 patients have developed clinical hypothyroidism. One patient had elevated thyroid parameters and clinical features of mild hyperthyroidism.

Additional clinical and laboratory data are included from seven patients with lithium associated hypothyroidism and three patients with lithium associated thyrotoxicosis who were not included in the survey population.
Diabetic Peripheral Neuropathy: Nerve Conduction Studies Before, During and After Carbamazepine Therapy
Authors: Chakrabarti A. K. , Samantaray S. K.
Published: March 2008

Summary: Diabetic peripheral neuropathy: Nerve conduction studies before, during and after carbamazepine therapy. A. K. Chakrabarti and S. K. Samantaray, Aust. N.Z. J. Med., 1976, 6, pp. 565–568.

Fifty‐four patients with diabetic peripheral neuropathy were treated with carbamazepine for a period of one year. Clinical assessment and nerve conduction velocity studies (NCV) were done periodically. Forty‐nine patients had symptomatic relief of all sensory manifestations but NCV remained essentially unchanged. Untoward effects of the drug were frequent but transitory. It was concluded that carbamazepine is a dependable drug for the treatment of symptomatic diabetic sensory polyneuropathy.
Clinical Pharmacology and Efficacy of Benorylate in Patients with Rheumatoid Arthritis
Authors: Champion G. D. , Day R. O. , Paull P. D. , Graham G. G. , Owen M. S. , Haski A. L. , Hills L.
Published: March 2008

Clinical pharmacology and efficacy of benorylate in patients with rheumatoid arthritis. G. D. Champion, R. 0. Day, P. D. Paull, G. G. Graham, M. S. Owen, A. L Haski and L. Hills, Aust. N.Z. J. Med., 1978, 8, pp. 22–28.

Benorylate, an ester of aspirin and paracetamol, was evaluated in 24 adult patients with rheumatoid arthritis. Benorylate dosage was individualized over a three week period, and subsequently, the patients were randomly allocated to continue dosage with benorylate or to change to placebo for one week. All measures of inflammation and pain worsened on the change to placebo. At the end of the double‐blind phase, significant differences were noted between the group who stayed on benorylate and the placebo group in the following parameters: pain index, articular index, functional index, the number of analgesic tablets taken, the duration of daytime rest and patients' and investigators' global assessments. There was no significant differences in the time to walk 50 feet while the differences in the duration of morning stiffness and grip strength were of marginal significance. The degree of relapse in the placebo group was most marked in patients who had attained plasma concentrations of salicylate above 130 μglml prior to the change to placebo. The mean adjusted daily dose of benorylate (±SD) was 11‐3 (±0–7) g and the mean plasma concentration of salicylate was 175 (±57) μgI ml.
Serum Ferritin as an Index of Body Iron Stores in Patients on Chronic Haemodialysis*
Authors: Craswell P. , Hunt F. , Davies L. , Russo A. , Goethart J‐ , Halliday J.
Published: March 2008

Summary: Serum ferritin concentrations have been measured serially over a 12 month period in 35 patients on chronic haemodialysis. All patients on haemodialysis received oral iron and vitamin supplements during the period of study. In 28 of the patients simultaneous bone marrow iron was also estimated. A significant correlation was found between serum ferritin concentration and bone marrow iron content. In all but two patients, oral iron supplements were sufficient to prevent a fall in the serum ferritin concentration during the period of observation. Chronic renal failure per se did not appear to affect the serum ferritin concentration.
Red Cell Survival in Haemoglobin Köln
Authors: Heaton D. C. , Lam‐Po‐Tang P. R. L. C.
Published: March 2008

Summary: Red cell survival was studied in a patient with heterozygous haemoglobin Köln using simultaneous chromate (51Cr) and di iso propyfluorophosphate (DF32P) labelling both before and after splenectomy. Before splenectomy the chromium elution rate was mildly increased. Splenectomy resulted in significant increase in red cell survival and return of the elution rate to normal.
The Prevalence of HBeAg and Anti‐HBe in an Institution for the Mentally Retarded
Authors: Gust I. D. , Dimitrakakis M. , Sharma D. L. B.
Published: March 2008

Summary: The prevalence of HBeAg and anti‐HBe in an institution for the mentally retarded. I. D. Gust, M. Dimitrakakis and D. L B. Sharma, Aust. N.Z. J. Med., 1978, 8, pp. 471–473.

The age specific prevalence of HBsAg and anti‐HBs was studied in 855 mentally retarded children and adults living in a large institution. The sera of every HBsAg positive patient was re‐tested for the presence of HBeAg and anti‐HBe.

Overall, 78.2% of subjects showed serological evidence of current or past infection with HBV. The carrier rate was highest in children and young adults and higher amongst subjects with Down's syndrome than with other forms of retardation. HBeAg was detected in 33‐9% of carriers and its prevalence also decreased with increasing age and was highest amongst subjects with Down's syndrome.
Toxic Autonomous Thyroid Nodule Following Neck Irradiation*
Authors: Scott R. S. , Brownlie B. E. W. , Bremner J. M.
Published: March 2008

Summary: Toxic autonomous thyroid nodule following neck irradiation. R S. Scott, B. E. W. Brownlie and J. M. Bremner, Aust: N.Z. J. Med., 1978, 8, pp. 521–522.

A 37‐year‐old male with a history of neck irradiation in childhood presented with thyrotoxicosis due to an autonomous thyroid nodule. Adjacent to the nodule was a radiation scar from radiotherapy administered 35 years previously. Hemithyroidectomy was performed and histological examination excluded malignant change. Long term follow‐up should continue to detect possible nodule formation in the contralateral lobe.
Sideroblastic Anaemia and Leukaemia in Multiple Myeloma
Authors: Phadke K. P. , Kwan Y. L. , Young S. G.
Published: March 2008

Summary: Sideroblastic anaemia and leukaemia in multiple myeloma. K. P. Phadke, Y. L. Kwan and S. G. Young, Aust. N.Z. J. Med., 1978, 8, pp. 539–543.

Two patients with IgA myeloma and one patient with kappa light chain disease developed sideroblastic anaemia from two to four years after the initial diagnosis. All had previously received radiotherapy and chemotherapy (melphalan and prednisone). In two patients the myeloma was quiescent when the sideroblastic change occurred. Leukaemia occurred in two patients two and seven months respectively after the diagnosis of sideroblastic anaemia was made. In one of them, the myeloma became active again at the same time. The development of sideroblastic anaemia may be a preleukaemic event and may be recognised by the appearance of a dimorphic blood film.
Concomitant IgA Nephropathy and Cyclical Neutropaenia
Authors: Nash H. , Binns G. F. , Clarkson A. R. , Beare T. H.
Published: March 2008

Summary: Concomitant IgA nephropathy and cyclical neutropaenia.

A case of concomitant cyclical neutropaenia and IgA nephropathy, a previously un‐described combination is reported. The patient has recurrent aphthous ulceration, and haematuria occurs with these episodes. The diagnosis of cyclical neutropaenia was based on the clinical features and serial peripheral blood studies, and a renal biopsy studied by light, electron and immunofluorescence microscopy in conjunction with the clinical features established the diagnosis of IgA nephropathy. Elevation of serum immunoglobulin, with a disproportionate elevation of IgA was found. The features of this case emphasise the importance of infection as an initiating event in the pathogenesis of IgA nephropathy, and they provide further evidence for the formation of poorly soluble immune complexes as a likely pathogenetic mechanism.
Virus‐Associated Malignant Diseases in Animals and Man
Authors: Jose David G.
Published: March 2008

Summary: Virus‐associated malignant diseases in animals and man
Multi‐System Immunologically Mediated Disease: T Lymphocyte Deficiency and Thyroid Immunologic Disease—A Report of Four Cases
Authors: Wall J. R. , Fang S. L. , Walters B. A. , Strakosch C. R. , Ingbar S. H. , Braverman L. E.
Published: March 2008

Summary: Multi‐system immunologically mediated disease: T lymphocyte deficiency and thyroid immunologic disease–A report of four cases.

Four cases are described of multisystem immunologically ‐mediated disease (systemic lupus erythematosus (two cases), polymyositis, and sarcoidosis) in association with thyroid autoimmunity. In all patients there was evidence of T lymphocyte deficiency, namely poor response of peripheral blood lymphocytes (PBL) to T cell mitogens (four cases) and failure or decreased ability to become sensitized to dinitrochlorobenzene (three cases), a/though two patients were ill and two were being treated with steroids. There was also evidence of B lymphocyte deficiency since PBL of no patient responded normally to pokeweed mitogen, a B and T lymphocyte mitogen. In two patients there was evidence of cell‐mediated immunity to human thyroid antigens. Although thyroid stimulating antibody was not detected in the one patient with Graves' disease tested, significant titres of thyroid antibodies were detected in all cases. Possible relationships between T lymphocyte deficiency, organ‐specific autoimmune disease and immunologically‐mediated multi‐system disorders are discussed.
The Clinical and Pathogenetic Significance of Rheumatoid Factors
Authors: Maini R. N.
Published: March 2008

Summary::The clinical and pathogenetic significance of rheumatoid factors. R N. Maini,Aust. N.Z. J. Med,1978, 8, Suppl. 1, pp. 51–56

Rheumatoid factors are immunoglobulins with antibody specificity for antigenic sites on the Fc part of the heavy chain of IgG. The heterogeneity of RF in terms of antigenic specificity and class of immunoglobulin is indicative of the complexity of the provoking immune response. There is little doubt that in many patients rheumatoid factors are autoantibodies which form part of immune complexes, and that complexes containing IgG rheumatoid factor appear to be of pathogenetic importance. A/though IgM rheumatoid factors are not specific for RA, their detection aids in the diagnosis and categorisation of rheumatoid arthritis. On the other hand, IgG rheumatoid factors occur in a variety of rheumatic diseases and are of little diagnostic value.
Pathogenesis of some Traumatic and Degenerative Disorders of Soft Tissue
Authors: Burry H. C.
Published: March 2008

Summary: :Pathogenesis of some traumatic and degenerative disorders of soft tissue. H C.

1. Trauma to soft tissues is associated with tissue rupture and formation of a haema‐toma.

2. Such lesions cannot be expected to resolve without complications in the absence of appropriate treatment.

3. Myositis ossificans should be anticipated in lesions of muscles adjacent to their attachments.

4. Chronic tendonitis and enthesopathies not associated with inflammatory connective tissue disease are primarily degenerative in nature and are probably the result of comparative ischaemia. Mesenchymoid transformation is a feature of both.
Intermittent Atrioventricular Block: Procainamide Administration as a Provocative Test*
Authors: Tonkin A. M. , Heddley W. F. , Tornos P.
Published: March 2008

Summary: Intermittent atrioventricular block: Procainamide administration as a provocative test. A. M. Tonkin, W. F. Heddle and P. Tornos, Aust. N.Z. J. Med, 1978, 8, pp. 594–602.

Twelve patients with clinical features suggesting possible intermittent high degree atrioventricular block were studied. All 12 patients had basic 1: 1 atrioventricular conduction but nine had an electrocardiographic pattern of bifascicular distal conduction disease (right bundle branch block with left anterior or posterior hemib/ock, or left bundle branch block). Intracardiac conduction was assessed by recording of the His bundle electrocardiogram and atrial pacing techniques, before and 20 minutes after intravenous administration of procainamide, in a dose of up to 10 mg/kg. Before procainamide administration, seven of the 12 patients had a prolonged H‐V interval (> 55 ms). Procainamide administration lengthened the H‐V interval in all 12 patients by 5–40 ms. In five patients, procainamide induced second or third degree AV block below the level of the bundle of His. It was concluded that the administration of procainamide may be a useful provocative test of distal conduction in patients with possible intermittent AV block.
Progesterone and Oestrogen Receptors in Human Breast Cancer
Authors: Holdaway I. M. , Mountjoy K. G.
Published: March 2008

Summary: Progesterone and oestrogen receptors in human breast cancer. I. M. Holdaway and K. G. Mountjoy, Aust. N.Z. J. Med, 1978, 8, pp. 630–638.

Receptors for progesterone were found in 27% of 98 human breast tumours, and for oestrogen in 57% of 191 tumours. With one exception, progesterone receptors were found only in tumours which also contained oestrogen receptors. Levels of oestrogen receptor in positive tumours rose significantly with patient age whereas progesterone receptors were unchanged. Progesterone receptor levels were lower in lymph node metastases than in primary tumours, and oestrogen receptor levels were lower in large tumours (> 5 cm diameter) compared to small lesions. Receptor levels were not significantly correlated with circulating concentrations of either oestrogen or prolactin. The implications of receptor measurements in assessing hormone responsiveness of breast tumours are discussed.
Exercise Testing in the Detection of Severe Coronary Artery Disease
Authors: Jelinek V. M. , McDonald I. G. , Schweitzer P. , Herman M. V. , Gorlin R.
Published: March 2008

Summary: The clinical value of exercise testing in the detection of severe coronary artery disease remains undefined. This question was examined in 289 men and 45 women. The diagnosis of coronary artery disease could be reliably made without exercise testing in patients with angina pectoris which markedly restricted walking or which was accompanied by pathological Q waves on the ECG. Such patients usually had coronary artery disease involving two or three major vessels.

Exercise testing was an aid to diagnosis in patients with a normal standard ECG and chest pain suspicious of myocardial ischaemia, either mild angina or atypical. When exercise testing resulted in both angina and ST segment depression in men, coronary artery disease was present in 38 of 41 (93%) of cases. On the other hand, three vessel disease was found in only six of 100 (6%) of men whose exercise test did not evoke angina and ST segment change. A normal exercise test in a woman with suspicious chest pain and a normal ECG was associated with normal coronary arteries in 14 of 15 (93%) of cases. It may be concluded that exercise testing is of most diagnostic value in the assessment of patients with a normal standard ECG and a differential diagnosis of mild angina pectoris and atypical chest pain.
Electrophysiology of Disopyramide in Man*
Authors: Ross D. , Vohra J. , Cole Penney , Hunt D. , Sloman G.
Published: March 2008

Summary: The electrophysiological effects of an intravenous dose of disopyramide phosphate (2 mg per kg body weight) were studied in 17 patients. Studies were performed with the patients fasting, unpremedicated, and off all medication for three days. Blood samples for estimation of serum levels of disopyramide were collected in 15 of these patients. The effects of intravenous disopyramide were maximal at five minutes, less marked at 20 minutes, and largely gone by 30 minutes after administration of the drug. Sinus cycle length and corrected sinus node recovery time were shortened significantly. No index of atrioventricular nodal function was significantly changed. Both atrial and ventricular effective refractory periods were significantly prolonged. Further impairment of intraventricular conduction occurred in six patients with bundle branch block on electrocardiogram or prolonged HV interval. In one of two patients with Wolff‐Parkinson‐ White syndrome, the bypass effective refractory period was prolonged.

These electrophysiological changes are similar to quinidine and quinidine like drugs. It is recommended that disopyramide should be used cautiously in patients with evidence of His Purkinje system disease since it may lead to higher degrees of intraventricular block.
Combined Cholinergic Antagonist and β2‐Adrenoceptor Agonist Bronchodilator Therapy by Inhalation
Authors: Marlin G. E. , Berend N. , Harrison A. C.
Published: March 2008

Summary: The bronchodilator effects of 40 μg ipratropium bromide (I) and 400 μg fenoterol (F) by pressurised aerosol and both drugs in combination were compared with placebo (P) in a double‐blind study in eight patients with chronic, partially reversible airways obstruction. The four treatments were (1) IP, (2) PF, (3) IF and (4) PP, with the second aerosol administered two hours after the first. Both drugs produced significant bronchodilatation for five hours, the response being greater and more rapid in onset with fenoterol. Both drugs in combination (IF) produced significant additive bronchodilatation from three to six hours after fenoterol. This additive effect may have been due to the improved lung function caused by ipratropium bromide and does not imply a synergistic effect. There were no side‐effects reported. The results suggest that both ipratropium bromide and fenoterol are effective bronchodilating agents in patients with chronic asthma.
The Synergistic Effect of Weight Loss and Changes in Dietary Lipids on the Serum Cholesterol of Obese Men with Hypercholesterolaemia: Implications for Prevention of Coronary Heart Disease
Authors: Blacket R. B. , Leelarthaepin B. , McGilchrist C. A. , Palmer A. J. , Woodhill J. M.
Published: March 2008

Summary: The hypolipidaemic effect of a low‐fat, low‐cholesterol diet, alone and in combination with weight reduction, has been evaluated in two groups of obese men with hypercholesterolaemia. In 41 men who lost 10.3 kg over 11 months and maintained their lower weight for 23.5 months serum cholesterol fell by 1.68 mmol/l and remained steady at lower weight. In 20 similar men, the controls, whose weight fell by 0.8 kg over 39.5 months, serum cholesterol fell by 0.80 mmol/l. There was a significant linear correlation between change in weight and change in serum cholesterol. The change in serum cholesterol in the weight losers was greater than could be accounted for by change in dietary lipids. Weight reduction and low‐fat, low‐cholesterol diets appear to have a synergistic effect in reducing serum cholesterol.
Family Study on the Kindred of an Adenosine Deaminase Deficient Child with Severe Combined Immunodeficiency
Authors: Lee C. H. , Ziegler J. B. , Rozenberg M. C.
Published: March 2008

Summary: A study was performed on the family of a child with severe combined immunodeficiency and deficiency of the purine salvage pathway enzyme, adenosine deaminase (ADA). Sixteen relatives over three generations were studied. Erythrocyte ADA levels clearly indicated the heterozygous status of five members. A sixth member, whose erythrocyte ADA level of 48 nmol/hr/mg Hb was within two standard deviations (32) of the mean (76) was shown by ADA determination on platelets to be clearly heterozygous. Similarly, consideration of ADA data of either serum, platelets or lymphocytes only, would have failed to identify all hetero‐zygotes. The survey shows that the identification of phenotype by the indirect means of enzyme level determination is enhanced by the simultaneous study of several tissues.
Adenocarcinoma of the Lung in Non‐Hodgkin's Lymphoma
Authors: Phadke K. P. , Manoharan A.
Published: March 2008

Summary: The development of a second neoplasm is a rare complication in patients with various types of primary malignancy. This report describes two patients with non‐Hodgkin's lymphoma who developed adenocarcinoma of the lung and malignant pleural effusion following many years of cytotoxic therapy. The value of cytological examination of the sputum and pleural aspirate, as well as fibreoptic bronchial biopsy in the diagnosis are emphasised. The higher incidence of this complication in patients with lymphocytic type of non‐Hodgkin's lymphoma may be due to their longer survival and probable basic immune defects which become overt after chemotherapy.
Morphological and Functional Interrelationships of Bone Cells and Matrix
Authors: Vernon‐Roberts B.
Published: March 2008

Summary: 1. Bone is unique in its combination of cells, matrix and mineral.

2. It has a dual function in skeletal and mineral homeostasis.

3. Cells which are functionally different act as coordinated units depending on a variety of signals which may be hormonal, ionic, mechanical and, possibly, electrical.

4. The coordinated activity of the cells is brought about by their having an intimate structural interrelationship, by the probability of their being subject to the influence of factors contained within an extra‐cellular fluid circulating around all the cells underlying the mesenchymal cell envelope, and by the possibility that the osteoclasts and osteoblasts do not represent an end‐stage in differentiation.

5. The understanding of the factors which normally control cellular differentiation and function may lead to methods of reversing bone loss, rectifying the effects of metabolic bone disease and promoting the healing of fractures.
Treatment of Paget's Disease with the Calcitonins*
Authors: Martin T. J.
Published: March 2008

Summary: Calcitonin has been used in the treatment of Paget's Disease of bone because of its ability to inhibit osteoclastic bone resorption. This results in a return of bone turnover towards normal, as reflected by urinary hydroxyproline and serum alkaline phosphatase. A plateau is reached with these parameters, at about 50% of the pre‐treatment level. The cause of this plateau is unknown, but does not indicate resistance to treatment, since it occurs with all forms of calcitonin. Most treated patients experience pain relief, and there is radiological and histological evidence of arrested progression of Paget's Disease in patients treated with calcitonin. Both primary and secondary resistance to calcitonin occur with all calcitonins, including homologous hormone. Antibodies develop commonly in patients treated with pig or salmon calcitonin, but antibody‐based clinical resistance has been demonstrated only in a few patients. Methods of selection of patients for treatment and of assessment of response are discussed, and treatment schedules summarized.
Atheromatous Coronary Artery Ectasia*
Authors: Baron D. W. , Branson J. A. , Morgan J. J.
Published: March 2008

Summary: Of 431 consecutive patients who underwent coronary arteriography during the twelve month period ending December 1976, 23 (5%) had angiographically documented coronary artery ectasia. Of these only five had “pure” or isolated ectasia, whilst 18 had ectatic disease combined with coronary artery stenoses.

Clinical findings that are significantly associated with ectasia are male predominance (96%), abnormal lipid patterns (64%), a positive family history of coronary artery disease (57%) and previous hypertension (50%). Anatomically, ectasia most often involved the right coronary artery (96%), then the circumflex artery (75%) and the left anterior descending artery (57%).

Only seven (five with severe proximal stenoses) of the 28 patients had coronary artery bypass grafts. Care should be taken not to overdiagnose narrow segments between ectatic, dilated segments as being obstructions. Failure to appreciate this resulted in two patients with isolated coronary artery ectasia having bypass grafts performed with little relief of their symptoms.
Viral Hepatitis and Intrahepatic Cholestasis of Pregnancy
Authors: Bennett N. McK. , Lehmann N. I. , Speed B. R.
Published: March 2008

Summary: Specific serological tests which are now available for the diagnosis of infection with hepatitis A and hepatitis B viruses, were used to distinguish viral hepatitis from other causes of liver disease in pregnancy. Forty‐nine (51·6%) of 95 pregnant patients had viral hepatitis, 24 hepatitis A and 25 hepatitis B. The majority of patients (26 of 28) presenting before 22 weeks gestation had viral hepatitis. By contrast, 23 (34·3%) of the remaining 67 patients presenting with abnormal liver function tests at ≫ 22 weeks gestation, had viral hepatitis; the majority of the remainder had features compatible with intrahepatic cholestasis of pregnancy. Although there were significant clinical and biochemical differences between the two groups, accurate diagnosis was only possible by using specific virological tests.
Fetal, Maternal, and Intrapartum Factors and their Effects on Cord Serum Cholesterol and Triglyceride*
Authors: Boulton T. J. C.
Published: March 2008

Summary: The effects of adverse maternal, fetal, and intrapartum factors on cord serum total cholesterol (TC) and triglyceride (TG) were studied retrospectively on a sample of 428 neonates comprising four subgroups: (1) 54 with isolated cord serum hypercholesterolaemia (HC); (2) eight with cord serum HC and hypertriglyceridaemia (HTg); (3) 70 with isolated cord HTg; and (4) 296 with normal cord serum TC and TG levels.

Low birth weight babies (< 2500 g) had higher levels of cord TG (P < 0·001) and TC (P < 0·1) than normal weight babies, as did pre‐term (less than 37 weeks gestation) babies, P < 0·05 for TG, P < 0·001 for TC, and postmature (over 41 weeks gestation) babies, P < 0·01 for TG. The regression coefficient between gestational age and TC was‐0·20 (P < 0·001), and for TG‐0·13 (P < 0·02).

Babies with low one and five‐minute apgar scores had higher means for TG (P< 0·001) with the coefficients of regression being 0·34 and 0·30, but no differences were present for TC. Those who had had signs of intrapartum distress, such as tachycardia and bradycardia, also had higher means for TG (P < 0·01), but their TC was lower than in the control group (P < 0 05).
Angiostrongyliasis Cantonensis
Authors: Scrimgeour E. M. , Burke W. J.
Published: March 2008

Summary: A case of Angiostrongyliasis cantonensis with eosinophilic meningoencephalitis, presenting in a Caucasian resident of Rabaul, Papua New Guinea, is described. Diagnosis was supported by serological studies. This appears to be the first report of a case from New Britain.
Nifedipine in the Treatment of Life Threatening Prinzmetal Angina
Authors: Campbell T. J. , Hickie J. B. , Michell G. , O'Rourke M. F.
Published: March 2008

Summary: Nifedipine is a non‐nitrate vasodilator which has proved effective, in oral form, in Europe1, Japan2, and the USA3for treatment of Prinzmetal Angina. The drug has not been used before in Australia. We report a patient with Prinzmetal's variant angina, complicated by recurrent syncopal episodes due to ventricular arrhythmias. The attacks were resistant to standard therapy except sublingual nitro‐glycerin but ceased completely during treatment with nifedipine.
Liver Disease Associated with Chronic Arsenic Ingestion
Authors: Cowlishaw J. L. , Pollard E. J. , Cowen A. E. , Powell L. W.
Published: March 2008

Summary: The association of chronic liver disease with long‐standing arsenic ingestion is well documented, although the spectrum and incidence of liver disease due to arsenic remain uncertain. We report two patients with chronic liver disease and arsenical skin changes that followed previous chronic arsenic ingestion. One patient developed macronodular cirrhosis and the other non‐cirrhotic portal hypertension with perisinusoidal fibrosis. The latter patient developed a primary liver cell cancer. There is only one previously reported case of malignant hepatoma in a non‐cirrhotic liver complicating chronic arsenicism. Lack of awareness of this uncommon but well described cause of chronic liver disease may account for a small proportion of patients with “cryptogenic” liver disease. Previous arsenic administration should be considered as a cause of chronic liver disease, especially when typical skin changes or internal neoplasia develop.
Gastro‐Colic Fistula Complicating Benign Gastric Ulcer in Analgesic Abusers
Authors: Coughlin G. P. , Willing R. L. , Hamilton D. W.
Published: March 2008

Summary: Two cases of gastro‐colic fistula occurring in analgesic abusers are described. In both patients, the fistulous communication was diagnosed at endoscopy and subsequently verified by upper gastrointestinal tract barium studies. Gastro‐colic fistula is a rare complication of benign peptic ulcer disease. Whilst salicylates and cortico‐steroids have been implicated as aetiological agents, abuse of compound analgesics has not previously been reported. Since the first description of gastro‐colic fistula in 17551, thirty documented cases associated with benign gastric ulcer have been reported.2,3Most often, gastro‐colic fistula occurs secondary to gastric or colonic malignancy.4Barium enema examination is the most accurate diagnostic study.5 Endoscopy has been confined to the visual inspection of the ulcer and establishing the benign nature of these lesions.
Oral Pindolol in Acute Evolving Myocardial Infarction
Authors: O'Rourke M. F. , Baront D. , Washington H. , Sammel N. , Cheminant D. Le
Published: March 2008

Summary: Oral pindolol in acute evolving myo‐cardial infarction. M. F. O'Rourke, D. Baron, H. Washington. N. Sammel and D. Le Cheminant, Aust. N.Z. J. Med., 1979, 9, pp. 408–411.

Pindolol was administered orally (5 mg 8th‐hourly) to 30 patients 5–19 (mean = 9·0 hrs) hours after onset of acute myocardial infarction. There were no serious side effects during the acute phase of infarction, only one hospital death and two late deaths at follow‐up 2–82 (mean = 37 wks) weeks after hospital discharge. In contrast to healthy volunteers, patients with acute infarction had unpredictable absorption of pindolol from the gastrointestinal tract; this was attributable in part to concurrent administration of narcotic analgesics.
Maternal Immunosuppression and Cytomegalovirus Infection of the Fetus*,†
Authors: Hayes K. , Symington G. , Mackay I. R.
Published: March 2008

Summary: Maternal immunosuppression and cytomegalovirus infection of the fetus. K. Hayes, G. Symington and I. R. Mackay, Aust. N.Z. J. Med., 1979. 9, pp. 430–433.

Prenatal cytomegalovirus (CMV) infection associated with severe brain damage was detected in an infant whose mother had been treated with prednisolone and azathioprine for systemic lupus erythematosus (SLE). Serology showed that maternal CMV infection had been acquired at least four months before pregnancy. Screening for CMV infection in pregnant women receiving immunosuppressive drugs is recommended.
Thiamphenicol as an Immunosuppressant in Active Systemic Lupus Erythematosus with Nephritis
Authors: Richmond D. E.
Published: March 2008

Summary: Thirteen patients with active systemic lupus erythematosus (SLE) and biopsy proven nephropathy were treated with thiamphenicol for two weeks. Laboratory indices of SLE disease activity (antinuclear factor, complement activity and ESR) were improved after the course of treatment in half of the patients and did not change significantly in the rest. Thiamphenicol may have value as an alternative to currently popular immunosuppressive drugs in the management of systemic lupus erythematosus.
Benign Rheumatoid Nodules
Authors: Burry H. C. , Caughey D. E. , Palmer D. G.
Published: March 2008

Summary: Nine cases in which subcutaneous rheumatoid nodules were observed in the absence of any evidence of rheumatoid arthritis are recorded. In four of these cases, the nodules appeared during adolescence or adult life, a very rare phenomenon. Synovitis occurred in only one patient, after an interval of 15 years, but it did not persist and other features of rheumatoid arthritis were not present. The siting of the nodules in the sub‐cutaneous tissue, the absence of features suggestive of rheumatic fever, necrobiosis lipiodica or fungal infection, and lack of any history of trauma, together with the histological appearance, supported a diagnosis of rheumatoid nodules. In all cases, serological tests for rheumatoid factor were negative but in the only case investigated with immunofluorescent staining, IgG and IgM were demonstrated in the biopsy material.

It is important to recognise the fact that these benign nodules do not necessarily indicate that the patient has rheumatoid arthritis, or will develop rheumatoid arthritis in the future. The possible relationship of such nodules to granuloma annulare is discussed.
An UnusuaS Case of Flaccid Paralysis of Both Lower Limbs Following Herpes Zoster
Authors: Chapman B. A. , Beaven D. W.
Published: March 2008

Summary: A 57‐year‐old man with left T8–9 cutaneous Herpes Zoster lesions and subsequent development of flaccid paralysis of both lower limbs is reported.

Viral studies strongly supported a diagnosis of Herpes Zoster. No other cause for the paralysis was found. The time interval between the cutaneous lesions and the motor weakness, the clinical course and good recovery suggest a causal relationship. The dermatomal and myotomal dissociation has been well‐documented on the ipsilateral side, but involvement of the contralateral side is rare. This would appear to be unusual in that there was bilateral weakness of “LMN type”.
Ocular Side Effects with 5‐Fluorouracil
Authors: Christophidis N. , Vajda F. J. E. , Lucas I. , Louis W. J.
Published: March 2008

Summary: The concentrations of 5‐fluorouracil in tears and plasma were studied in eight patients receiving the drug for carcinoma of the colon. The drug was measured by a gas liquid chromatographic method and found to be present only in the tears of patients with excessive lacrimation.

In three patients with watery eyes the peak concentration in tears (16–23.8 μg/ml) occurred 15 minutes after IV administration and this corresponded with the end of the distribution (α) phase in the plasma when the plasma levels ranged from 18–26 μg/ml. In five patients without eye symptoms the drug was undetectable in the lacrimal fluid even though they had similar plasma levels (15–25 μg/ml) of 5‐fluorouracil. The volumes of distribution and plasma clearance rates were similar in the two groups [being 0.2–0.52 (mean =0.33) 1/kg and 612–978 (mean = 850) mllmin respectively in patients with excessive lacrimation and 0.13–0.79 (mean = 0.36) 1/kg and 435–1138 (mean = 831) mllmin respectively in the five patients without symptoms.].

It appears that 5‐fluorouracil produces irritation of the lacrimal apparatus in about 30% of patients on the drug and in association with this appears in the tears where it may be responsible for the reported irritation and fibrosis of the tear duct.
Distributions and Interrelations of Coronary Risk Factors in a Community Sample of Auckland Men*
Authors: Spicer J. , McLeod W. R. , O'Brien K. P. , Scott P. J.
Published: March 2008

Summary: Distributions and interrelations of blood pressure, serum cholesterol, triglycerides, urate and glucose, cigarette and alcohol consumption and ECG characteristics were assessed in a community sample of 524 Auckland men aged 30–55. The distributions of these varables were generally similar to those found in other New Zealand samples, indicating that New Zealand levels of coronary risk factors lie in the upper reaches of the US and European range. Notable amongst the interrelations found were the pattern of relationships between serum cholesterol, triglycerides and urate, and the association of both body mass and alcohol intake with urate level.
Exercise Testing in Congenital Aortic Stenosis
Authors: Hossack K. F. , Neilson G. H.
Published: March 2008

Summary: Treadmill exercise testing was performed on 23 patients with isolated congenital aortic stenosis. It was found that eight patients, with a negative exercise test and a normal rise in systolic blood pressure on exercise, had gradients less than 45 mmHg. Fifteen patients with gradients greater than 50 mmHg had positive exercise tests and their systolic blood pressure did not rise normally. It is suggested that left heart studies to measure aortic valve gradients can safely be postponed if an exercise test is negative. Serial exercise testing of such patients will give an indication when left heart catheterization should be considered.
Juvenile Reiter's Syndrome
Authors: Conaglen J. , Grennan D. M. , Signal T. , McArthur J. E. , Lucasi R. , Palmer D. G.
Published: March 2008

Summary: A case of Reiter's syndrome occurring in an 11‐year‐old, pre‐pubertal boy is described. The boy was a heterozygote for the histocompatibility antigen B27 and other arthritic members of his family included his mother with colitic arthritis and an aunt with ankylosing spondylitis. His HLA‐B27 negative sibs have remained well. Shigella, Salmonella and Yersinia organisms have been previously incriminated as precipitating factors in some patients with Reiter's syndrome but no evidence of recent infection with any of these agents was found in this patient. The case is reported because of the rarity of the condition at this age.
An Assessment of the Clinical Use of Glyceryl Trinitrate in a Hospital Outpatient Population*
Authors: Maclean F. K. , Hunt D. , Marty J. J. , Slornan J. G. , Shaw J.
Published: March 2008

Summary: An assessment of the clinical use of glyceryl trinitrate in a hospital outpatient population.

F. K. Maclean, D. Hunt, J. J. Marty, J. G. Sloman and J. Shaw, Aust. N.Z. J. Med., 1980, 10, pp. 12–14.

Despite the availability of information on the use of glyceryl trinitrate (GTN) in standard texts, in practice many patients fail to obtain maximum benefit from GTN. This study of an Outpatient population, documents the patients' knowledge of the use and precautions which should apply to GTN and records the ways in which these patients took the drug. Fifty patients who regularly took GTN (>5 tablets per week} were asked a series of questions by the same interviewer. Forty‐nine of the 50 patients took GTN for the relief of chest pain, but only 34 patients knew that the drug could be used to prevent chest pain. Although 48 patients kept their bulk supply of GTN in the original container, over 40% transferred some or all of the tablets to other containers and locations. Seventy per cent of patients knew that GTN tablets deteriorate with time. However, knowledge of the factors which influence the rate of deterioration was lacking. Less than half the patients knew that the prompt relief of pain or the local effects on the buccal mucosa could be used as simple tests of the activity of tablets. It is recommended that all physicians should take more time to explain to their patients how to use glyceryl trinitrate correctly.
Acute lntrahospital Stroke Mortality—An Improving Picture
Authors: Byrne E. , Tiltman R. C. B.
Published: March 2008

Summary: Acute intrahospital stroke mortality—an improving picture. E. Byrne and R. C. B. Tilt man, Aust. N.Z. J. Med., 1980, 10, pp. 21–24.

Case fatality ratios for the stroke syndrome are reported for patients admitted to two South Australian Teaching Hospitals during the period 1968–77. A fall in intra hospital acute phase stroke mortality was seen from 28.1 % of stroke admissions in 1968–69 to 18.3% in 1976–77. Male stroke mortality rate fell from 28.1% to 17.0% and female mortality rate from 28.4% to 19.9% over this period. Changes in admission criteria and in duration of hospitalization do not appear to account for this improvement in mortality figures. The age distribution of the total inpatient stroke population did not change significantly over this period. An increase in all hospital admissions of 46% over the period was paralleled in the stroke subgroup 15.5%. No improvement in therapeutic methods over the period in question appears to fully account for the improvement in mortality figures and it is inferred that these figures indicate an overall decrease in stroke severity on presentation.
Immunological Status May Predict Clinical Outcome in BCG Treated Melanoma
Authors: Reynolds P. M. , Grimsley G. , Dawkins R. L. , Byrne M. J. , Zilko P. J.
Published: March 2008

Summary: Immunological status may predict clinical outcome in BCG treated melanoma. P. M. Reynolds. G. Grimsley. R. L. Dawkins, M. J. Byrne and P. J. Zilko. Aust. N.Z. J. Med., 1980, 10, pp. 39–43.

Twenty‐seven patients with surgically reseated stage Il or III malignant melanoma were treated with bacillus Calmette‐Guérin (BCG) and followed prospectively to determine whether relapse could be predicted. Peripheral blood mononuclear (lymphocyte plus monocyte) counts (PBM), T and B cell counts, phyto‐haemagglutinin (PHA) cytotoxicity, PHA transformation, antibody‐dependent cell‐mediated cytotoxicity (ADCC) and serum immunoglobulin concentrations were studied before and during therapy. Patients ultimately classified as having a poor clinical outcome (inoperable recurrence) were compared with those with a more favourable outcome. Prior to therapy, poor outcome patients had lower PBM and T cell counts but there was some overlap. After three months, these differences were more pronounced. Low PHA cytotoxicity was also associated with poor outcome; again the differences were more apparent at 3 months than prior to therapy.

These results suggest that PBM, T cell counts and PHA cytotoxicity may predict poor outcome some months before inoperable recurrence is apparent clinically
Thyrotrophin Displacement Activity of Serum Immunoglobulins in Health and Disease
Authors: Croxson M. S. , Lim T. M. T. , Graham F. M. , Ibbertson H. K.
Published: March 2008

Summary: Thyrotrophin displacement activity of serum immunoglobulins in health and disease. M. S. Croxson, T. M. T. Lim, F. M. Graham and H. K. Ibbertson, Aust. N.Z. J. Med., 1980, 10, pp. 151–156.

A radioreceptor assay for TSH displacement activity (TDA) was employed as an index of thyroid stimulating immunoglobulins (TSIg) in serum from patients with autoimmune thyroid disease. TDA was > 20 in normal subjects (37/37), patients without thyroid disease (36/38), non‐toxic goitre (18/19) and toxic nodular goitre (16/17) and was significantly lower in Nepalese subjects with severe endemic goitre. TDA was > 20 in 84% of patients with untreated hyperthyroid Graves' disease (70/83), in Hashimoto's thyroiditis (3/17) and following subtotal thyroidectomy (8/14) or 131I therapy (7/11), but was ≤ 20 in euthyroid patients treated with carbimazole (58/59) and during spontaneous remission (18/19). Serial TDA measurements during antithyroid drug therapy suggested that carbimazole has a direct effect in reducing TS/g concentration but that TDA is not a useful prognostic indicator of short term relapse or remission
Angiocardiography and Exercise Testing at One Month After a First Myocardial Infarction
Authors: Sammel N. L. , Wilson R. L. , Norris R. M. , Brandt P. W. T. , Stuckey J. G.
Published: March 2008

Summary: Angiocardiography and exercise testing at one month after a first myocardial infarction. N. L. Sammel R. L. Wilson, R. M. Norris P. W. T. Brandt and J. G. Stuckey Aust. N.Z. J. Med., 1980 10, pp. 182–187

The results of exercise testing (77 patients), left ventriculography and coronary arteriography (78 patients) are presented for men under the age of 60, one month after a first myocardial infarct. Cineangiocardiography revealed that patients with anterior infarction (n = 25) had both poorer left ventricular function and more totally occluded vessels than those with either inferior (n = 33) or subendocardial infarction (n = 20). In contrast, patients with inferior and subendocardial infarction had a greater proportion of myocardium supplied by sub‐total lesions likely to be haemodynamically significant (75%‐99% cross sectional area loss). Subendocardial infarction was also characterised by the best left ventricular function and the fewest number of total coronary occlusions

Stress testing showed that the combination of ischaemic ST segment changes and angina during exercise was 91% predictive of severe coronary disease (equivalent to triple vessel disease) while no angina in the presence of a negative test was 81% predictive of mild or moderate disease. Stenoses of 75%‐99% cross sectional area loss were more common when angina occurred during exercise testing, and both angina and ischaemic ST segment changes occurred within ten minutes in all four patients with haemodynamically significant left main coronary artery lesions

Our data supports the usefulness of exercise testing after a first myocardial infarct and may provide valuable baseline information in the analysis of long term prognosis