bluuebunny/crossref_metadata_2025 huggingface dataset:
AN EVALUATION OF NUCLEAR ARYL SULPHATASE ACTIVITY AS AN AID TO THE CYTOLOGICAL DIAGNOSIS OF ACUTE LEUKÆMIA
Authors: EKERT HENRY , DENETT XENIA
Published: September 2017

A cytochemical method for the detection of aryl sulphatase in the nuclei of cells was applied to bone marrow smears of 16 children and two adults with leukæmia. Four children with an acute undifferentiated leukæmia were found to have nuclear aryl sulphatase, as seen in acute lymphatic leukæmia. The clinical course of these patients has been similar to that seen in acute lymphatic leukæmia. It is suggested that this test will facilitate a cytological diagnosis in acute leukæmia, particularly in those cases found to be undifferentiated by other criteria.
RHEUMATOID LUNG DISEASE WITH REPORT OF A CASE
Authors: BASTEN ANTONY , CAMENS I. , SCHWARTZ C. J.
Published: September 2017

The clinical, laboratory and pathological features are described of a rare example of rheumatoid lung disease, in which a spontaneous pneumothorax was found in association with cavitating pulmonary nodules, rheumatoid involvement of the pleura and a unilateral pleural effusion. The relevant literature is reviewed.
LEUCOCYTES CONTAINING BACTERIA IN PLAIN BLOOD FILMS FROM PATIENTS WITH SEPTICÆMIA
Authors: SMITH H.
Published: September 2017

A search for infected cells was made with the low power (× 10 or × 20) objective in plain blood films from patients known to have, or suspected of having, septicæmia. It was found that scanning of a film in this way for a short time will detect even small concentrations of infected cells. Infected leucocytes occurred in highest concentration in the first drop of blood issuing from the previously unmanipulated ear lobe. They occurred most frequently in films in which there was also an increase in mononuclear cells containing inclusions of corpuscular origin, and were found whether or not the patient had recently been given apparently effective antibiotic treatment.

Consideration is given to the requirements for a diagnosis of septicæmia from the presence of infected cells in blood films and the distinction of bacteria from other structures in leucocytes which may resemble them.

A search for infected leucocytes in a plain blood film of the first drop of blood from the ear lobe appears to be a useful procedure in routine investigation of patients who may have septicæmia.
THALASSÆMIA MINOR IN AUSTRALIANS OF NORTHERN EUROPEAN EXTRACTION: A REPORT OF FIVE FAMILIES
Authors: JOHNSEN J. K. , IBBOTSON R. N. , HORWOOD J. M.
Published: September 2017

Five families of heterozygous beta (type 1) thalassæmia minor with elevated hæmoglobin A2values and no “known” Mediterranean ancestry are presented. Four families are of Anglo‐Saxon origin, and one family is of German descent. All five propositi and an isolated sixth patient with an elevated hæmoglobin A2value were referred with hypochromic microcytic anæmia unresponsive to iron therapy. The purpose of this paper is to draw attention to the incidence of thalassæmia minor in Northern Europeans resident in Australia, and to emphasize the importance of full investigation of all cases of iron refractory hypochromic microcytic anæmia, to avoid the over‐treatment with iron of persons with thalassæmia minor.
POST‐TRANSFUSION MONONUCLEOSIS
Authors: FOSTER KEAY M.
Published: September 2017

Thirty‐two patients with circulating atypical mononuclear cells appearing after blood transfusions are described. The term “post‐transfusion mononucleosis” is introduced to describe this finding. In all but one of these cases, the transfused blood was known to have been freshly donated before the transfusion.

Serial blood films from most of these patients have been reviewed, and the atypical mononuclear cells are described. They resemble the transformed lymphocytes which develop in tissue culture from small lymphocytes under the influence of phytohæmagglutinin.

Splenomegaly, fever and lymphocytosis are common features of post‐transfusion mononucleosis, but the neutrophil count has usually been normal or reduced. Eosinophilia, lymphadenopatny and anæmia have rarely been found. Elevated titres of sheep cell agglutinin have been found in several cases, but in only one case did the type of agglutinin constitute a positive Paul Bunnell test.

Post‐transfusion mononucleosis may mimic infectious mononucleosis and acute or subacute bacterial endocarditis, and the criteria for the differentiation of these diseases are discussed.

The ætiology of the syndrome is unknown, and the hypothesis is made that it may be a graft rejection response directed against viable transfused foreign lymphocytes contained in freshly donated blood.
CALCIUM‐47 KINETICS IN OSTEOPOROSIS
Authors: MELICK R. A.
Published: September 2017

With the use of Ca47, the exchangeable calcium (E) and the accretion of calcium to bone (A) have been estimated in 15 subjects—four normal, five osteoporotic, one chronically immobilized, three acutely immobilized, and two receiving prednisolone for active arthritis. Low values for exchangeable calcium and calcium accretion were found in one normal subject, two osteoporotic subjects and the chronically immobilized subject. High accretion rates were found in one acutely immobilized subject and in both subjects with arthritis.

The low values in some osteoporotic subjects and the normal values in others are consistent with published reports, and suggest either that calcium kinetics are not greatly disturbed in osteoporosis, or that this method lacks sensitivity.

Some of the problems in the interpretation of radiocalcium data are discussed.
SOME FACTORS AFFECTING RIGHT AND LEFT ATRIAL WEIGHTS AND VOLUMES AND TOTAL HEART WEIGHT
Authors: GORDON RICHARD , NEILSON GRAEME , SILVERSTONE HAROLD
Published: September 2017

The hearts from 156 patients who came to routine hospital autopsy were examined. The amount of epicardial fat was assessed by macroscopic examination, the amount of atrial fat was assessed by microscopic examination and the thickness of the body fat was measured at the midline ventral incision. The patient's age, sex, and height were recorded, and the degree of rigor mortis of the heart assessed. The hearts were weighed, the volume of each atrium was measured, and the atria were individually dissected and weighed.

Correlations were sought between atrial weights and volumes and the patient's age, sex, height, amount of body and heart fat, and the degree of rigor mortis of the heart.

The total heart weight, both atrial weights and both atrial volumes were greater for males than for females. For each sex the right atrial volume was significantly greater than the left atrial volume, but right and left atrial weights did not differ significantly. Significant positive correlations existed between right and left atrial weights. For both sexes, also, each atrial weight was correlated with its corresponding atrial volume.

For males, atrial magnitudes were positively correlated with body height and with the thickness of body fat. For females, left atrial volumes only were positively correlated with the thickness of body fat, and there were no positive correlations with height. For females, but not for males, both atrial weights were positively correlated with age. The total heart weight for males was greatest in taller, fatter subjects, but for females it was greatest in shorter, fatter subjects. For both sexes, atrial magnitudes correlated positively with total heart weight, independently of the amount of heart fat. The amount of epicardial fat (assessed by macroscopic examination) was positively correlated with the thickness of subcutaneous fat, while the amount of atrial fat (assessed by microscopic examination) was not.
HÆMORRHAGE INTO THE UPPER PART OF THE GASTRO‐INTESTINAL TRACT IN THREE PATIENTS WITH HERITABLE DISORDERS OF CONNECTIVE TISSUE
Authors: GRANT A. KERR , ALDOR T. A. M.
Published: September 2017

Three patients with rare, heritable disorders of connective tissue presented with hæmorrhage of the upper part of the gastro‐intestinal tract. The latter is not commonly described in Ehlers‐Danlos syndrome, but may be a presenting feature in Grönblad‐Strandberg syndrome. Two sisters with the former condition demonstrated a remarkably similar distribution of connective tissue defects, including multiple jejunal diverticula. Recognition of the underlying disorder in the latter syndrome depends upon competent ophthalmoscopic examination.
ADULT CYSTIC FIBROSIS PRESENTING WITH MECONIUM ILEUS EQUIVALENT AND DIAGNOSED BY SELENOMETHIONINE SCANNING OF THE PANCREAS
Authors: QUINLAN M. F. , WAYS N. J. , JOSKE R. A.
Published: September 2017

A case of cystic fibrosis in a man, aged 28 years, is described, in whom the presenting feature was obstruction of the small bowel due to impacted bowel content—” meconium ileus equivalent “. The presence of pancreatic insufficiency was confirmed by the result of a pancreas scan with 75Se‐labelled selenomethionine. The use of pancreatic scanning in the diagnosis of chronic pancreatic insufficiency is discussed.
THE INVESTIGATION OF HYPOPITUITARISM
Authors: LAZARUS L.
Published: September 2017

A dynamic scheme is described for the investigation of patients suspected of having hypopituitarism. The hypothalamus and pituitary are investigated as a single functional unit by the use of basal studies of each trophic hormone and the subsequent hormonal response to stimuli. The basal studies include the measurement of the total 17‐oxogenic steroid content in the urine, total pituitary gonadotrophin content in the urine, thyroidal uptake of 131I and serum growth hormone levels. The stimuli used include insulin‐induced hypoglycæia and the administration of metyrapone, pyrogens and vasopressin. The majority of patients with hypopituitarism have partial hypopituitarism, and unihormonal deficiencies are not uncommon. Classification of the disorder should be on a functional basis.
SOME EFFECTS OF THE INTRAVENOUS ADMINISTRATION OF CALCIUM IN MAN
Authors: SMALLWOOD R. A.
Published: September 2017

Calcium was administered by intravenous infusion or injection into 19 subjects, in doses ranging from 180 to 864 mg. The effects observed were bradycardia and sinus arrhythmia, an increased pulse pressure, shortening of the Q‐T
c interval with depression and inversion of T waves, and an increase in gastric secretion. Atropine prevented the development of the bradycardia, sinus arrhythmia and the increase in gastric secretion, but did not prevent the increase in pulse pressure. None of the changes occurring ran parallel with the serum calcium levels, and with the exception of the T‐wave changes, which persisted after the serum calcium levels had returned to normal, they appeared to be related to the acute rise in serum calcium levels.
THE INTERPRETATION OF THE RESULTS OF ORAL GLUCOSE TOLERANCE TESTS IN OLDER SUBJECTS
Authors: DE COEK NANETTE M.
Published: September 2017

The results are presented of glucose tolerance tests on 85 apparently non‐diabetic male subjects, 58 of them aged over 54 years. The results were as follows : 47 “normal” ; 11 “glucose tolerance test diabetics” ; 15 “lag‐storage”; 9 “group C” ; and 3 “unclassifiable”. In the older groups of the subjects studied, there was a tendency for the peak of the curve to be displaced to the right, and it is therefore suggested that the test period for the G.T.T. should be increased to three hours for subjects aged over 54 years, and that diagnostic post‐prandial blood sugar levels should be estimated at this time. The association of abnormal glucose tolerance and the clinical manifestations of vascular disease is discussed, as well as the possible effect of medication being taken by the patients. It is concluded that, although there is a decline in glucose tolerance as age advances, it is likely to be overemphasized if a two‐hour test is used, and inadequate notice taken of current medication.
RELATIONSHIP BETWEEN S‐T SEGMENT DEPRESSION DURING EXERCISE AND INCREMENTS IN THE URINARY EXCRETION OF 3‐METHOXY 4‐HYDROXY MANDELIC ACID IN MEN WITH CORONARY HEART DISEASE
Authors: NESTEL P. J. , HAMMOND JUDY
Published: September 2017

The urinary excretion of the major catecholamine metabolite, 3‐methoxy 4‐hydroxy mandelic acid (VMA) was measured in subjects with coronary heart disease before and after an exercise study. The electrocardiographic changes induced by exercise were measured continuously before and throughout exercise. The following findings were observed :

The magnitude of the S‐T segment change was significantly related to the post‐exercise increment in urinary VMA excretion.

The magnitude of the S‐T segment change was also significantly related to the rise in heart rate.

3. The rise in heart rate was significantly related to the increment in the urinary excretion of VMA.

Although the mechanisms responsible for these findings have not been established, we conclude that an association exists between sympathetic nervous responsiveness during exercise and the development of myocardial ischxmia.
THE RESPONSE OF THE BLOOD PRESSURE TO AN INFUSION OF ANGIOTENSIN IN PATIENTS WITH ESSENTIAL, MALIGNANT AND RENOVASCULAR HYPERTENSION
Authors: MORGAN TREFOR
Published: September 2017

The angiotensin infusion test was performed on 251 patients.

The results of the test were reproducible and not affected by hypotensive therapy in the case of patients with essential hypertension.

The mean pressor dose was the same for normotensive subjects and for patients with hypertension with or without disease of the renal parenchyma.

The mean pressor dose for patients with renal artery stenosis or malignant hypertension was increased. The pressor dose fell to normal when hypertension was controlled. Renal artery surgery improved hypertension in nine patients. The pressor dose was normal pre‐operatively for four patients.

The angiotensin infusion test was able to detect most patients with renal artery stenosis. The large number of false positive responses and the occurrence of some false negative responses reduce its value as a screening test.
THE HÆMORRHAGIC SYNDROME OF EARLY CHILDHOOD
Authors: LOVRIC V. A. , JONES R. F.
Published: September 2017

A syndrome manifested with an acquired hæmorrhagic tendency after the neonatal period in 25 children is described. The results of coagulation studies were indicative of severe lack of factors partaking in the prothrombin complex formation. The clotting indices were sufficiently low to account for spontaneous bleeding.

Clinical improvement coinciding with return to normal of hæmostatic mechanisms was recorded after vitamin K therapy.

Malabsorption of vitamin K was considered the cause of hæmorrhages in 12 chronically ill, wasted children.

No ætiological factors responsible for this lack of vitamin K could be detected in the other 13 patients. Some presented with acute bilateral subdural hæmatoma, and the implications of this finding are discussed.

Vitamin K prophylaxis may be desirable in all surgical patients in the first four months of life.
A TRANSIENT CIRCULATING ANTICOAGULANT LEADING TO ACUTE RENAL FAILURE
Authors: Hicxs, N. D. , SAGE R. E. , LAWRENCE J. R.
Published: September 2017

A case is reported of an extremely severe, transient, antithrombin‐type anticoagulant, which resulted in gross hæmaturia, clot obstruction and acute renal failure. No cause for the appearance of the anticoagulant was discovered. The patient made a full recovery and remains well one year later.

This is believed to be the first report of any circulating anticoagulant with such a transient course.
STUDIES OF THE NATURE OF PLASMA THYROID STIMULATING ACTIVITY IN HYPERTHYROIDISM
Authors: HOFFMANN M. J. , MASON E. K. , GOOD B. F. , HETZEL B. S. , FERGUSON K.
Published: September 2017

Previous reports from this and other laboratories indicate the importance of the activity of abnormal plasma long‐acting thyroid stimulator (LATS) characteristic of thyrotoxicosis in relation to the various clinical features of the disease.

Studies on the nature of this agent have now been carried out by comparison of its thyroid stimulating activity in the 131I‐labelled mouse with that of bovine pituitary thyrotropic stimulating hormone (TSH) and plasma from hypothyroid patients in which an excess of pituitary TSH has been demonstrated, as well as by chemical studies.

A short‐acting response with a maximum at three hours is characteristic of pituitary TSH. A long‐acting response with maximum at eight hours or longer is characteristic of LATS. However, in the present study a long‐acting response with a maximum at eight hours has been demonstrated after multiple injections of bovine TSH. A long‐acting response can also be produced by injecting bovine TSH after it has been mixed with an appropriate concentration of rabbit antiserum to bovine TSH. These findings indicate that the pattern of response is not necessarily a distinguishing feature differentiating LATS and TSH.

In contrast to the activity of TSH, LATS activity is unaffected by an antiserum to bovine TSH prepared in the rabbit. However, LATS activity is diminished by mixing it with an antiserum to human 7S gamma globulin prepared in the sheep, which in turn fails to affect the thyroid stimulating activity of bovine TSH on plasma from hypothyroid patients. These findings indicate that there is a distinct immunological difference between LATS and TSH.

Large plasma samples from three thyrotoxic patients have been subjected to gel filtration (with the use of a “Sephadex” G‐200 apparatus). LATS activity was mainly confined to the 7S gamma globulin peak; although there was a degree of overlap into the macroglobulin and albumin peaks, starch gel electrophoresis revealed 7S gamma globulin was invariably a component of these fractions. Further purification was achieved by DEAE‐ “Sephadex” chromatography. This produced three fractions—the first two were found to have LATS activity and to contain 7S gamma globulins on starch gel electrophoresis, while the third contained beta globulins and albumin but was devoid of 7S gamma globulin and was inactive in the mouse assay.

These findings are consistent with the findings of other laboratories, in that they clearly indicate that LATS belongs to the 7S gamma globulins and is therefore probably an antibody. These data strongly support clinical evidence indicating the importance of immunological mechanisms in the pathogenesis of hyperthyroidism. The possibility of hyperthyroidism being an autoimmune disorder is discussed.
CYTOPLASMIC LINKAGE BETWEEN LYMPHOID CELLS IN MIXED CULTURES
Authors: MAGLAURIN B. P.
Published: September 2017

Cytoplasmic connections have been demonstrated between living lymphoid cells, both in the early and late stages of prolonged mixed lymphocyte cultures.

In early culture, these connections appear to have an anchoring function. By linkage between cells in rosette formation, they may permit rapid activation of large numbers of uncommitted small lymphocytes.

Late in mixed culture, cytoplasmic linkage between cells is more striking. It is suggested that this linkage could provide a pathway for the direct transfer of antibody or other toxic agents from immune cell to target cell.
PROTEIN CATABOLISM IN STARVATION AFTER DIETS HIGH AND LOW IN PROTEIN
Authors: UTLEY D. , WHYTE H. M.
Published: September 2017

Two subjects ate diets high (HP) and low (LP) in protein for 14 days, then continued them for a further three control days, starved for three days (taking only water, salt and vitamins) and then took 300 grammes of sucrose each day for three days.

Urea and creatinine clearance rates were 17% to 38% lower on the LP than on the HP diet.

Starvation was easily tolerated after the HP diet but was severely distressing after the LP diet.

Starvation caused the daily urinary nitrogen loss to decrease after the HP diet from 14·8 to 11·9 grammes, and to increase after the LP diet from 6·8 to 12·2 grammes. The suggested explanation is that protein catabolism reverted in starvation to the rate which was appropriate for metabolizing the amount of protein habitually eaten before the experiment.

The practical issue is that tissue destruction during a foreseeable period of starvation, as after surgery, and which is of particular importance to patients with renal failure, is not substantially reduced by short‐term pre‐conditioning with a low protein diet.
THE USE OF THE XANTHINE OXIDASE INHIBITOR, ALLOPURINOL, IN THE CONTROL OF HYPERURICÆMIA, GOUT AND URIC ACID CALCULI
Authors: EMMERSON B. T.
Published: September 2017

Allopurinol, an inhibitor of xanthine oxidase, was administered to 11 patients with various disorders of urate metabolism and observations were made of the resultant effects on the serum and urine concentrations of urate and of the oxypurines, xanthine and hypoxanthine. The renal clearance rates of urate, creatinine and the oxypurines were estimated before and during allopurinol therapy. Doses of allopurinol of between 300 and 400 mg. per day restored the serum urate concentrations to normal in all cases and were associated with a slight rise in the serum concentrations of the oxypurines. The urinary excretion of urate fell and that of the oxypurines rose. The total urinary excretion of urate and the oxypurines was reduced by allopurinol therapy. The oxypurines were excreted well even in the presence of renal impairment. No serious complications of therapy were observed, although some patients continued to be troubled by attacks of acute gouty arthritis during the first few months of therapy.
JEJUNAL BIOPSY IN MALIGNANT DISEASE
Authors: DELLER DONALD J. , MURRELL TIMOTHY G. C. , BLOWES ROMALA
Published: September 2017

The appearance of the small bowel mucosa and mucosal measurements are described in 45 patients with various malignant conditions and compared with the findings in 25 control subjects. The mean villous height and mean total mucosal thickness were significantly reduced in the patients with malignant disease. The mucosa in malignant disease was normal in 38%, and showed simple atrophy in 31%, partial villous atrophy in 29% and subtotal villous atrophy in 2% of cases. The mucosal changes were related to the duration of illness and the degree of loss of weight. They were less frequently detected in patients with bronchial carcinoma. The presence of metastases, the treatment given, the interval before death and the presence of steatorrhœa were not related to the abnormal mucosa. Steatorrhœa was detected in one‐third of the patients, but it was usually slight. Steatorrhœa did not account for weight loss and abnormalities in the small bowel mucosa appeared to be unrelated to the steatorrhœa.
GARDNER'S SYNDROME WITH ADRENAL CARCINOMA
Authors: MARSHALL W. H. , MARTIN F. I. R. , MACKAY IAN R.
Published: September 2017

A young woman with familial polyposis of the colon, multiple sebaceous cysts and osteomata (Gardner's syndrome) presented with Cushing's disease associated with carcinoma of the adrenal gland. This appears to be the first recorded case of Gardner's syndrome with adrenal carcinoma, and the first case wherein a metastasizing tumour other than carcinoma of the colon has been fully documented.
BACTERIAL ENDOCARDITIS DUE TO NEISSERIA PERFLAVA IN A PATIENT HYPERSENSITIVE TO PENICILLIN
Authors: BRESLIN A. B. X. , BIGGS J. C. , HALL G. V.
Published: September 2017

A case of bacterial endocarditis caused by Neisseria perflava is presented; the virulence of the organism is stressed and evidence is given that the organism was hæmolytic in vivo.

The case adds another to the nine previously reported cases of bacterial endocarditis in patients hypersensitive to penicillin being treated with steroids and penicillin G.

Some evidence is given to suggest cross allergy between penicillin G and cephaloridine.

Early recourse to aortic valve replacement had a marked influence on the subsequent outcome for this patient.
IDIOPATHIC ŒSOPHAGEAL EPITHELIAL CAST
Authors: DONALD K. J. , PATERSON R. A.
Published: September 2017

A case of idiopathic œsophageal epithelial cast is described. The patient suffered little discomfort and there were no complications. Previously reported cases are briefly reviewed and the mechanism of production is discussed. A comparison with a case of œsophageal cast resulting from the ingestion of hydrochloric acid is made.
SUBMUCOSAL JEJUNAL HÆMORRHAGE WITH PHENINDIONE
Authors: LEIGH J.
Published: September 2017

A case of subacute intestinal obstruction arising during anticoagulant therapy is presented. Pre‐existing symptoms obscured early diagnosis, and the patient died despite all attempts at therapy.

Post‐mortem examination revealed a single hæmatoma in the jejunum, blood‐stained peritoneal fluid, coronary thrombosis and cholelithiasis.

The case is compared with previously reported similar cases.
THE SOURCE OF A GASTRIC SECRETORY INHIBITOR FROM HUMAN SALIVA
Authors: BAUME PETER E. , BAXTER CHRISTINE H. , NICHOLLS ANNETTE
Published: September 2017

The contribution made by oral bacteria to the content of substances in human saliva which inhibit rat gastric acid secretion on intravenous injection was assessed. It was found that, when growth of bacteria in saliva was prevented, the saliva had no capacity to inhibit rat gastric acid secretion, whereas when no antibacterial precautions were taken for three hours saliva did possess such activity. It was found that oral bacteria cultured free of saliva possessed the capacity to inhibit gastric acid secretion. Three oral bacteria (Neisseria catarrhalis, α‐hæmolytic Streptococcus spp. and Lactobacillus casei) were studied in detail, and were found to inhibit rat gastric acid secretion to 50% of control values in doses of 400 to 800 μg. per kilogram. Studies on fragmented bacteria indicated that inhibitory activity resided in the supernatant fraction derived mainly from the bacterial cytoplasm. Preparations of bacterial cell walls were without any inhibitory activity. It was shown that the effect on gastric acid secretion was not due simply to the embolic effects of bacterial injection, and it is concluded that the phenomenon is probably due to a specific metabolic effect of a bacterial cell component.
ABSORPTION OF PHENOXYMETHYL PENICILLIN IN PATIENTS WITH STEATORRHŒA
Authors: DAVIS A. E. , PIROLA R. C.
Published: September 2017

The absorption of phenoxymethyl penicillin has been studied in normal subjects and in patients with steatorrhœa by the estimation of the serum values obtained after the oral administration of a standard dose. Patients with gluten‐sensitive enteropathy failed to absorb phenoxymethyl penicillin, while patients with other forms of steatorrhœa had serum curves within the normal range.

It is considered that in the acute stage of any illness phenoxymethyl penicillin, and presumably other drugs, should be administered by the parenteral route to patients with gluten‐sensitive enteropathy.
STUDIES CONCERNING A COMPUTER ANALYSIS OF PATIENTS WITH PRIMARY, SECONDARY OR STRESS POLYCYTHÆMIA
Authors: CAPON I. N. , JELLETT L. B.
Published: September 2017

Previously published hæmatological data concerning patients with primary, secondary or stress polycythæmia have been analysed by digital computer. The mathematical model utilized is presented, and the results of the analysis have been related to the clinical and laboratory findings. It is emphasized that different mathematical methods of treating the data may produce variable results. Accordingly, the results of computer analysis should be regarded critically and with an awareness of the limitations of the mathematical methods involved.

Complex data are often assembled under less than ideal conditions for subsequent computer analysis. However, the present study concerning previously published hæmatological data indicates that such material may be amenable to certain statistical techniques provided that the subsequent computer results are interpreted carefully.

It is further emphasized that computer analysis of any medical data must involve close cooperation between clinician and mathematician if the resultant information is to be regarded as accurate.
EXCRETION OF BROMSULPHALEIN AND DEPLETION OF HEPATIC GLUTATHIONE IN THE RATE
Authors: EDWARDS K. D. G. , JAVITT NORMAN B. , WHEELER HENRY O. , BRADLEY STANLEY E.
Published: September 2017

In previous studies, bromsulphalein (BSP) was shown to be excreted in the bile mainly as a conjugate with the tripeptide, glutathione. In the present studies, BSP given by single intravenous injection in a dose of 0·2 μMole per gramme of body weight has been found to produce a highly significant transient fall in the concentration of glutathione in the liver of the non‐fasting rat—from 7·8 to 5·5 μMole per gramme 60 minutes after injection (P<0·001). Minimum concentrations were observed at 45, 60 or 75 minutes, when most of the BSP had been excreted. The concentration in the liver of one of the amino acid constituents of glutathione, glutamic acid, concurrently rose significantly from 3·3 to 4·1 μMole per gramme of liver (P=0·01). In further studies, the constant intravenous infusion of BSP at 0·48 μMole per minute for an average time of three hours in fasting rats was also found to deplete the liver of glutathione; mean values fell significantly from 6·2 to 3·6 μMole per gramme (P=0·01). Prior treatment with cysteine, an essential amino acid constituent of glutathione, increased liver glutathione content, and prevented depletion on administration of BSP.

Chemical studies of the major BSP conjugate, synthesized in vitro or isolated from rat bile, revealed conjugation of BSP and glutathione in a one‐to‐one relationship. Autoradiography of paper chromatograms of bile obtained after the administration of 35S‐labelled glutathione and then BSP by intravenous injection ro minutes later showed a diversion of radioactivity from the usual metabolites of glutathione to the BSP conjugates. It was concluded that depletion of hepatic glutathione is caused by removal of glutathione from the liver cells by conjugation molecule for molecule with BSP and excretion into the bile, and not by decreased synthesis or increased catabolism other than by conjugation. On the contrary, the rate of synthesis of hepatic glutathione may be increased during the action of BSP and for some time thereafter, and catabolism by the usual pathways appears to be decreased.
ISOLATION OF CYTOMEGALOVIRUS FROM THE BLOOD LEUCOCYTES OF A PATIENT WITH POST‐TRANSFUSION MONONUCLEOSIS
Authors: FOSTER KEAY M. , JACK IAN
Published: September 2017

Cytomegaloviæmia was demonstrated in an adult female patient who was suffering an episode of post‐transfusion mononucleosis, as a consequence of the administration of a large volume of fresh blood. The primary nature of this infection was confirmed by demonstration of a complement‐fixing antibody rise during the course of the illness to a final titre of 1 : 512. The virus was isolated from unpurified blood leucocytes, and again one week later from purified blood lymphocytes.

Although a newly acquired infection with cytomegalovirus (CMV) has been demonstrated in this case, its ætiological role cannot be confidently assessed. The likely source of the virus is regarded as being one or more of the blood donors, and the possibility of a primary infection or a reactivation of a latent infection has been considered.

Antibody titrations were carried out on eight sets of stored sera from patients with post‐transfusion mononucleosis. Four of these showed a significant rise in antibody titre and only one set gave negative results. These results are consistent with the CMV infection having occurred in seven of these patients at the time of their episode of pest‐transfusion mononucleosis. The suggestion is made that a revision of the criteria for the utilization of fresh blood for certain groups of patients may become necessary.
BIOCHEMICAL AND CLINICAL STUDIES IN FAMILIAL GOITRE CAUSED BY AN IODOTYROSINE DEIODINASE DEFECT
Authors: NIALL H. D. , WELLBY M. L. , HETZEL B. S. , HUDSON BRYAN , CHENOWETH R. A.
Published: September 2017

Clinical and biochemical details of a Greek Cypriot family suffering from hypothyroidism and goitre are reported. Of eight children three (two males and one female) were hypothyroid and had goitres and low serum protein‐bound iodine and elevated serum cholesterol levels. These three subjects were unable to deiodinate orally‐administered 131I‐labelled diiodotyrosine (D131IT). The other children and their parents were euthyroid, and administration of D131IT to the father and one other child (female) revealed normal deiodination. Administration of D331IT to the mother and another sibling (both euthyroid clinically and without goitre) resulted in somewhat higher values than the normal, consistent with a partial defect.

The iodine deficiency secondary to the biosynthetic defect was corrected in two subjects by the injection of 4 ml. of iodized oil. In one of these, the total thyroxine level in the serum was normal two months later.
POTASSIUM DEPLETION: EFFECTS ON INTRACELLULAR pH AND ELECTROLYTE DISTRIBUTION IN SKELETAL AND CARDIAC MUSCLE
Authors: IRVINE R. O. H. , DOW J. W.
Published: September 2017

An experiment was designed to study in the rat the effects of dietary potassium depletion on skeletal and cardiac muscle, with particular reference to changes in potassium and hydrogen ion gradients across the cell membranes. A fall in plasma potassium content was accompanied by a considerable reduction in the potassium content of skeletal muscle, but only a small fall in the potassium content of cardiac muscle. However, the rise in the potassium ion gradient in cardiac muscle was twice that in skeletal muscle.

The potassium‐depleted rats showed an extracellular alkalosis, but the intracellular pH of skeletal muscle (measured with 14C‐labelled 5,5‐dimethyl‐2,4‐oxazolidinedione) fell. There was no significant relationship between the intracellular pH and potassium content of cardiac muscle, but the rise in potassium ion gradient was accompanied by a fall in intracellular pH and a rise in the hydrogen ion gradient. Significant curvilinear relationships were found between potassium and hydrogen ion gradients across skeletal and cardiac muscle cell membranes.

It is suggested that changes in the potassium ion gradient, with accompanying changes in the hydrogen ion gradient, play a more important part than changes in potassium content, in causing disturbances of cardiac rhythm. In potassium depletion, the fall in the intracellular pH of skeletal muscle, and the relationship between potassium and hydrogen ion gradients, may be due to reduced efficiency of the process responsible for the active extrusion of hydrogen ions from the cell.
INTESTINAL LYMPHANGIECTASIA WITH HYPOMAGNESÆMIC TETANY
Authors: ZIMMET P. , BREIDAHL H. D.
Published: September 2017

This report concerns a patient suffering from intestinal lymphangiectasia, and recurrent tetany not responding to calcium and vitamin D. Hypomagnesæmia was demonstrated, and the tetany was relieved by magnesium therapy. Measurement of the plasma ionized calcium content showed it to be in the tetanic range. This returned to normal after magnesium infusion, and the tetany was relieved concurrently with this.
THE SIGNIFICANCE OF VARIOUS BACTERIA IN CHRONIC BRONCHIAL DISORDERS AS DETERMINED BY BACTERIAL ANTIBODY DETECTION
Authors: BURNS M. W.
Published: September 2017

The relative significance of the pathogenic bacteria found in the respiratory tract (Hamophilus influenzæ, Streptococcus pneumoniæ, Staphylococcus aureus, Pseudomonas aeruginosa and Klebsiella) as causes of bronchial infection in the chronic respiratory disorders chronic bronchitis, bronchiectasis, asthma and cystic fibrosis was assessed by detecting specific precipitating antibodies in the serum of affected subjects and comparing their frequency with that in healthy controls. The predominant pathogen in such disorders was found to be H. influenzæ, with Strep. pneumoniæ playing a subsidiary role. In bronchiectasis and cystic fibrosis, Staph. aureus, Ps. aeruginosa and Klebsiella are significant pathogens, but not in chronic bronchitis. The true value of such antibody tests is reinforced by the finding that no patient demonstrated specific antibody to a neisseria extract, Neisseria sp. being generally regarded as non‐pathogenic in the respiratory tract.

The known failure of antibody titres against H. influenzæ to alter with infection is discussed, and reasons are given which might explain how this phenomenon can occur when this organism is the cause of the infection.
STUDIES OF SERUM LONG‐ACTING THYROID STIMULATOR (LATS) IN RELATION TO EXOPHTHALMOS AFTER THERAPY FOR THYROTOXICOSIS
Authors: HETZEL BASIL S. , MASON EDITH K. , HWA KWAN WANG
Published: September 2017

Observations have been made on a series of 30 thyrotoxic patients before and after therapy, with particular attention to exophthalmos (measured by the Hertel exophthalmometer) and serial determinations of serum levels of protein‐bound iodine (PBI) and long‐acting thyroid stimulator (LATS).

In 14 cases in which there was an exacerbation of exophthalmos (mean maximal increase of 2·8 mm. Hg) there was a greater fall in serum PBI levels (7.3 µg. per 100 ml.) than in 16 cases in which there was no such exacerbation (3.5 µg. per 100 ml.), although initial serum levels of PBI were the same in the two groups. The serum LATS level was more likely to be initially elevated in the group showing exacerbation. and a further rise was observed more frequently in this group following therapy, whether with antithyroid drugs, surgery or radio‐iodine.

Suppression of serum levels of LATS with azathioprine or steroids did not significantly affect the exophthalmos which had already developed in two cases.

These observations suggest that a determination of serum level of LATS could be carried out advantageously before therapy. If a high level is seen, then exacerbation of exophthalmos is more likely to occur. Immunosuppressive therapy may be indicated in addition to antithyroid drug therapy. surgery or the use of radio‐iodine if exacerbation is to be prevented.

Further studies are suggested to try to define more clearly the susceptible group of patients and to assess the value of immunosuppressive therapy in preventing exacerbations of exophthalmos.
DIABETES MELLITUS AND MYOCARDIAL INF ARCTION
Authors: BAILEY R. R. , BEAVEN D. W.
Published: September 2017

Established diabetes mellitus was present in 6% of men and 12% of women (total for both sexes 8%) in a series of 500 consecutive patients admitted to hospital with proven myocardial infarction. As the local adult community diabetes prevalence rate only amounts to 4 % among New Zealanders of European descent, the presence of an increased proneness to myocardial infarction among diabetics is suggested.

When the present group of patients with diabetes mellitus was carefully matched against a group of non‐diabetic controls who also had myocardial infarction, there was found to be a significantly higher 48‐hour hospital mortality rate in the former group. A history of previous cardiac failure, hypertension and myocardial infarction was also significantly more frequent among the diabetic patients, as was an episode of painless infarction.
BONE LESIONS IN PANCREATITIS
Authors: SPERLING M. A.
Published: September 2017

A case of traumatic pancreatitis in childhood, associated with metastatic fat necrosis and extensive bone lesions, is presented. The evolution of the bony changes is described and the possible mechanisms of production are briefly discussed. The paucity of the number of previous reports is stressed, but the impression is gained from the literature that bone lesions associated with pancreatic disease are more frequent than is appreciated.
COLCHICINE TOXICITYl
Authors: BRUNS B. J.
Published: September 2017

A case of self‐administered overdosage of colchicine is described. Despite gastrointestinal, hærnopoietic, neurological, hepatic and renal damage, together with alopecia, stomatitis, fever,transient hypertension and arthralgia, the patient survived.

This wide range of toxic effects has been recorded in animal experiments, but seldom occurs in humans. Elevation of the blood pressure has not previously been reported in this condition.
ASSESSMENT OF BODY COMPOSITION IN NORMAL AND OBESE SUBJECTS
Authors: GRACE C. S. , GOLDRICK R. B.
Published: September 2017

SUMMARY Multiple anthropometric measurements, which included those of weight, height, skinfold thickness, bone diameters and limb circumferences, together with estimations of creatinine excretion, were performed on 52 male and 42 female healthy subjects, both obese and of normal weight.

Fat mass was estimated from two equations, which had been derived by previous workers from measurements of body density, and combined total body water content and body density. One was based on weight and skeletal measurements, and the other on the iliac crest circumference and triceps skinfold thickness. It was shown that there was close agreement between these two estimates, even in very obese subjects, thus extending the observations made by the original authors. When the mean of these two values was used as the reference value for fat mass, it was found that the latter could be simply predicted in both sexes from weight/height2 and percentage ideal weight calculations and in males from iliac crest circumference. The error of prediction was less than 6·8 kg. (twice the S.D.). Prediction was better (error less than 5·2 kg.) in both sexes using both weight/height2 and the iliac crest circumference. Skinfold thicknesses were of less value in predicting fat mass. These conclusions only apply to Western populations of this type of body build, in whom fat is almost exclusively responsible for variations in bulk. In interracial studies, skin fold measurements may give a better estimate of relative obesity.

With creatinine excretion as our index of muscle mass, we found that no body measurement was of value in estimating muscularity. The best parameter was fat‐free weight, but this was of poor value, especially in obese males. It emphasizes that muscle forms a very variable proportion of fat‐free weight. To obtain a reliable estimate of muscularity in population studies it appears essential to estimate creatinine excretion.
ACUTE MITRAL INCOMPETENCE
Authors: SLOMAN GRAEME , HUNT DAVID , HARE W. S. C.
Published: September 2017

We have reported the occurrence of acute mitral incompetence in 22 patients. The mitral incompetence was considered to be secondary to ruptured chordæ tendineæ in 12 patients and to papillary muscle infarction in 10 patients. In three, the mitral leak was secondary to papillary muscle rupture.

The clinical manifestations have been reviewed and attention drawn to the need to differentiate the signs of acute mitral incompetence from combined aortic and mitral valve disease or from muscular subaortic stenosis. The clinical signs, radiographs and hæmodynamic studies are all helpful in this diagnosis.

It is important to recognize acute mitral incompetence so that appropriate treatment can be commenced. In those not responding adequately to a medical régime, surgical correction of the mitral incompetence should be considered. The results of the surgical treatment of acute mitral incompetence are reported in seven patients, there being a good result in four. A satisfactory outcome is more likely in those patients with ruptured chordæ and a previously normal myocardium. In patients with papillary muscle infarction and severe mitral incompetence, valve replacement may be required. Because of the underlying coronary disease, the outcome in this group will be less favourable.
INDUCTION OF ALCOHOL DEHYDROGENASE IN LIVER AND GASTRO‐INTESTINAL TRACT
Authors: MISTILIS STEVEN P. , GARSKE ANGELA
Published: September 2017

Experiments were designed to determine whether the increased rate of ethanol clearance previously demonstrated in alcoholics, in normal humans and in rats following prolonged alcohol ingestion is due to an increase in activity of enzymes involved in its metabolism. Alcohol was given in various doses to 56 rats, and alcohol dehydrogenase (ADH) and lactic dehydrogenase (LDH) assayed in liver, bile, colon, stomach and small intestine. Results were compared with 13 controls and rats given either actinomycin D or cycloheximide.

Results of our experiments clearly show that the activity of ADH and LDH in liver, stomach and small intestine significantly increases with administration of single and repeated doses of alcohol, and the effect persists for a significant time. The effect of alcohol appears to be specific, as increased activity in enzymes not involved in its metabolism was not found. Increased ADH activity could be blocked by actinomycin and cycloheximide which suggests that alcohol induced de novo synthesis of this enzyme protein.

The increase in activity of the rate‐limiting enzyme, ADH, by its substrate ethanol, provides a plausible explanation for the observed tolerance in both rats and man conditioned by prior administration of alcohol. The increase in LDH, a terminal enzyme involved in ethanol metabolism, provides further indirect evidence that ethanol can be metabolized at a faster rate through the normal pathway. The finding of both ADH and LDH in significant amounts in stomach and small intestine in both normal and alcohol‐fed rats suggests that ethanol can be metabolized to a significant extent in extrahepatic sites. This is contrary to the current view that alcohol is metabolized entirely by the liver, and that the multiple metabolic derangements in the alcoholic are the consequence of its obligatory metabolism in that organ.
ZOLLINGER‐ELLISON SYNDROME : A REPORT OF THREE CASES
Authors: ANTIC R. , GRANT A. KERR , MEADOWS R.
Published: September 2017

Three patients, who exhibited many of the classical clinical features of Zollinger‐Ellison syndrome, are presented. In the first patient, inadequate total gastrectomy contributed to death. In the second patient, total gastrectomy was effective, and in the third patient excision of a solitary pancreatic nodule in a lymph gland and partial gastrectomy has led to cure. In this patient there was associated hyperplasia of the parathyroid glands. Gastric secretion studies proved extremely reliable in two patients. Serum bioassay contributed to the diagnosis in one patient.
ACTIVE CHRONIC HEPATITIS WITH POSITIVE L.E. CELL TEST AND LUPUS NEPHRITIS
Authors: FUNG W. P. , CHEW B. K. , TAN K. K.
Published: September 2017

A case of active chronic hepatitis with a positive L.E. cell phenomenon and terminal acute renal failure secondary to lupus nephritis is reported in a Chinese girl of 10 years of age. This patient presented initially with an acute hepatitis which was associated with hypergammaglobulinæmia, raised immuno‐globulin levels and evidence of renal involvement. Liver biopsy showed marked piecemeal necrosis with rosette formation, a picture of active chronic hepatitis. After seven months she developed acute renal failure, acute cardiac failure and severe anæmia. There was persistent jaundice and hepatomegaly. Tests for L.E. cells gave positive results on three separate occasions. She died in renal and liver failure. Necropsy material showed cirrhosis and the changes of lupus nephritis.
The Application of Computers to Medical Records
Authors: Gledhill V. X. , McPherson T. A. , Mackay I. R.
Published: September 2017

This paper describes a system for the storage and retrieval by computers of components of the medical record. This system has been in operation for 18 months and there are over 550 clinical records stored on magnetic tape, representing some 700 separate patient admissions. The system stores data of identification, diagnosis codes, the summary of the medical record, results of laboratory tests, consultants' opinions and details of treatment. Three programmes have been written to process this data. The first provides for any number of printouts of the record of a patient's most recent admission. The second, the “update” programme, merges new records into their correct sequence on the magnetic tape. The third, the “record retrieval” programme, allowed a patient's complete medical record to be printed out as needed from the information on magnetic tape.

The present project has as the ultimate goal a computer‐based Patient Information Centre (PIC) which will receive, contain and transmit all relevant medical data concerning patients in hospital; the data in this information system could be available through computer consoles at any desired site within the hospital.