bluuebunny/crossref_metadata_2025 huggingface dataset:
The Nephrotic Syndrome in New Guinea–A Clinical and Histological Spectrum
Authors: Powell Keith C. , Meadows Robert
Published: March 2008

Summary: The clinical and biochemical features of 36 New Guinean patients suffering from the nephrotic syndrome are outlined. In 29 the histological pattern is also presented. In this study minimal lesions are uncommon and even in children account for only 20% of the cases. The dominant pathological type is a proliferative glomerulonephritis. The histological profile is similar to that found by African workers many of whom believe that, particularly in the case of children, the parasite P. malariae causes the disease. Such an aetiological relationship remains to be established for New Guinea. The patients with minimal lesions are prednisone‐dependent. Immunosuppressives (mostly azathioprine) are disappointing in those with minimal or proliferative lesions.
Small Intestinal Morphology in Aboriginal Children
Authors: Walker‐Smith J. A. , Reye R. D. K.
Published: March 2008

Summary: Small intestinal morphology of 44 small intestinal mucosal biopsies taken from Australian aboriginal children were examined histologically, and also freshly with the dissecting microscope. The findings were compared with similar observations made in 91 biopsies from control Australian children of European descent. The morphological appearances using each method of examination were placed into grades or groups and the two methods compared.

An increased prevalence of abnormal mucosae was found in the biopsies from aboriginal children as compared to biopsies from the controls, yet only one had the typical appearances found in coeliac disease. Six aboriginal children, however, appeared to respond to a gluten‐free diet. In three this intolerance to gluten appeared to be transient, but in the remainder appeared to be more permanent. Further observation is necessary to establish the diagnosis of coeliac disease in these children.

Histological assessment and examination with the dissecting microscope complement each other, however, a particular histological grade did not correspond always to a particular dissecting microscope group, but rather to a range.
New Requirements for Physician Training and Admission to the College
Authors: Mulhearn R. J.
Published: March 2008

New training procedures for those medical graduates who seek to become physicians and to be admitted to The Royal Australasian College of Physicians are in the course of introduction and will apply, in the main, to those who graduate at the end of 1971 and in subsequent years.
Parkinson's Syndrome: Aetiological Factors and Certain Clinical Features
Authors: Sutherland John M.
Published: March 2008

Summary: The aetiology of Parkinsonism is either idiopathic or symptomatic being secondary to encephalopathy, drug medication, or atherosclerotic changes. Occasional cases are due to chronic head injury in conjunction with a “punch drunk” syndrome. Incidence, prevalence and mortality studies are reviewed and genetic factors considered. Atypical presentations are described.
The Medical Management of Parkinson's Disease Before the Introduction of L‐dopa
Authors: Ebeling Peter
Published: March 2008

Summary: The concept of cholinergic dominance constituting a rational basis for the use of anti‐cholinergic drugs in Parkinson's disease is referred to and the role of such drugs, physiotherapy, antidepressants and amantadine hydrochloride is discussed. The limited scope of the cholinergic blocking drugs in alleviating akinesia is stressed and the not infrequent occurrence of unpleasant side effects is mentioned together with means of combating such symptoms.

Tricyclic anti‐depressants are recommended when depression is present.

Amantadine hydrochloride provides an initial favourable response in up to 50–66% of patients although improvement may not be maintained. The relative freedom of amantadine from side effects and the greater potency by comparison with conventional anti‐Parkinsonian remedies represents an advance in treatment although the ultimate role of amantadine in relationship to L‐dopa remains uncertain. A daily dose of 200 mg is recommended.
A Preliminary Report of Australian Trials with L‐dopa
Authors: Selby G.
Published: March 2008

Summary: Trials were commenced in Australia in several major neurological centres in December 1969. Details of the participants in the trial are described and also the methods employed. Criteria for the assessment of results are described in full and results are presented in detail. Impressive improvement was evident in akinesia, rigidity, gait, speech defects, tremor, hand‐writing, emotional state, depression and autonomic disturbances.

Side effects are analysed and discussed together with significant laboratory findings.

It is concluded that results of the trial are similar to reports from many earlier investigators from various parts of the world and that L‐dopa is many times more effective than any drug hitherto available in the treatment of Parkinson's Disease.
Neuropathic Arthropathy: A Report of Two Cases
Authors: Frewin D. B. , Downey J. A. , Feldman Frieda , Myers S. J.
Published: March 2008

Summary: The case histories of two patients suffering from neuropathic arthropathy are presented. One of them had Charcot“s disease of the lumbar spine secondary to a syphilitic infection. The second case, who was thought to have syringomyelia, gave a history of recurrent dislocation of the (R) shoulder. Clinical and radiological, examination of this joint suggested that it was of the neuropathic type. The pathophysiology and treatment of Charcbt's joints is briefly discussed.
Congestive Cardiac Failure and Intracranial Arteriovenous Communications in Infants and Children
Authors: Hope R. , Izukawa T.
Published: March 2008

Summary: Fourteen infants and children with intracranial arteriovenous fistulae are presented. They were seen by the Cardiology department at the Hospital for Sick Children over an eighteen year period from 1954 to 1972.

Two separate groups were distinguished. Older infants and children tended to present with neurological problems. Hydrocephalus and seizures were common. Heart murmurs and abnormal electrocardiograms were still frequent in this group. Cardiac failure did not occur. These children had a wide variety of arteriovenous malformations. In contrast, the group of infants presenting in the first week of life had severe cardiac failure without exception. All died despite attempted surgical palliation of the fistula in two cases. Neurological signs were present in some but were over‐shadowed by the severe cardiac failure. Cyanosis or a history of cyanosis at some stage was present. Cyanosis may be due to several different mechanisms.

Twelve of the fourteen children had continuous cranial murmurs. However, only in one case was the diagnosis suspected clinically. The murmurs were usually detected after the diagnosis had been made at catheterization and angiography. Auscultation of one‐hundred unselected neonatal heads by us, has shown that the presence of a murmur is rare. The importance of listening for cranial bruits in the newborn child with cardiac failure is re‐emphasized.
Factors Affecting the Decline of FEV1 in Chronic Bronchitis
Authors: Barter C. E. , Campbell A. H. , Tandon M. K.
Published: March 2008

Summary: A prospective survey of the progression of ventilatory impairment in 56 subjects with mild chronic bronchitis has been carried out over four and a half years. The forced expiratory volume in one second (FEV1) declined by the mean annual rate of 0.05 ± 0.06L. This re‐presents a highly significant annual deterioration of ventilatory function (P < 0.0005). The rate of decline was not related to the initial level of the FEV1 or to the number of exacerbations of bronchitis, but it was related to the age of the subject. As is usual amongst chronic bronchitic patients there was evidence of a mild degree of reversible airway obstruction as measured by response of the FEV1 to isoprenaline. The degree of reversible airway obstruction at the beginning of the study was found to be related to the subsequent rate of decline of the FEV1 (r = 0.50, P < 0.001). Taking this relationship into account, the decline in the FEV1 was more marked in smokers than in non and ex‐smokers. Among the smokers the serious rates of decline of the FEV1 tended to occur in those with increased degrees of reversible airway obstruction.

It is postulated that in chronic bronchitis even a minor degree of reversible airway obstruction may reflect an under‐lying asthmatic tendency. If so some pathogenic mechanism related to asthma may influence the rate of decline of the FEV1 in chronic bronchitis.
Elevation of Serum Bilirubin and Blood Urea in Pneumonia
Authors: Douglas R. M. , Devitt L. , Macartney B.
Published: March 2008

Summary: In a study of adult patients with pneumonia in Papua New Guinea, the serum bilirubin was elevated in 45% of 42 bacteremic and 23% of 402 nonbacteremic cases and blood urea was elevated in 55% of bacteremic and 26% of non‐bacteremic episodes. Both abnormalities occurred more frequently in patients with extensive consolidation and neither was related exclusively to pneumococcal infection. Review of available evidence suggests that both prerenal and renal factors are operative in causing elevation of blood urea in pneumonia and that, similarly, elevation of bilirubin is of complex origin resulting from both pre‐hepatic and hepatic dysfunction.
Simultaneous Assessment of Thyroid Structure and Function with the Gamma Camera using Pertechnetate:A Comparison with Radioiodine and Biochemical Diagnosis
Authors: Marion M. A. , Ronai P. M. , Pain R. W. , Wise P. H.
Published: March 2008

Summary: Thyroid structure and function have been simultaneously assessed using 99mTc‐pertechnetate and a gamma camera in an initial ‘pilot’ study using 83 patients and a subsequent study of 512 patients.

The morphology of the gland shown by this technique has been compared with rectilinear scans using both 99mTc and 131I. The results show that gamma camera scintiphotos with 99mTc provide superior delineation of thyroid structure compared with the rectilinear scanner using either 99mTc or 131I.

Thyroid function assessed by 99mTc uptake at 40 minutes and measured with the gamma camera has been compared with 3 hr and 24 hr 131I uptakes and also with biochemical estimations of total thyroxine, thyro‐binding index and free thyroxine index. The 99mTc uptake was shown to be unreliable in the diagnosis of hypothyroidism, but it is as reliable as 131I uptakes in the diagnosis of hyperthyroidism. Visualisation of gland structure is always necessary, for the 99mTc uptake is less reliable in nodular goitres than in diffuse goitres. The currently available measurements of circulating thyroid hormone are more accurate than uptake measurements in the assessment of thyroid function.
Severe Hypercapnia Associated With Metabolic Alkalosis Due to Pyloric Stenosis
Authors: Saunders N. A. , Carter J. , Scamps P. , Vandenberg R.
Published: March 2008

Summary: A patient with severe hypercapnia (PaCO2= 75 mm Hg) secondary to metabolic alkalosis is described. The patient had normal sensitivity to inhaled carbon dioxide after recovery. The hypercapnia was considered to be caused by a combination of severe metabolic alkalosis, hypochloraemia, hypokalaemia, de‐hydration and azotaemia, all of which were secondary to persistent vomiting caused by pyloric stenosis. The mechanisms of ventilatory depression during alkalosis, including the roles of hypochloraemia and hydrogen ion depletion, are discussed.
Pericarditis in Acute Myocardial Infarction
Authors: McLean K. H. , Bett J. H. N. , Saltups A.
Published: March 2008

Summary: In 1505 patients with acute myocardial infarction (Ml) pericarditis was diagnosed most often in those with anterior transmural ECG changes. Those with pericarditis had a significantly greater hospital mortality and peak serum lactic dehydrogenase (LDH) levels and a greater incidence of left ventricular failure (LVF).

The patients reported here1 and our methods of study2, 4 have been described.
Leucocyte Function in Paraproteinaemia**
Authors: Ziegler J. B. , Hansen P. J. , Penny R.
Published: March 2008

Summary: Cellular immunity has been studied by means of lymphocyte response to PHA, delayed hypersensitivity and skin window responses in 23 patients with myeloma (14 1gG, 9 1gA) and 14 patients with macroglobulinaemia.

In the myeloma patients, 14% had abnormal PHA response and 29% were anergic. In those with macroglobulinaemia, 29% showed abnormal PHA response and 57% were anergic. In myeloma, the abnormal PHA response was due to a serum inhibitor.

Abnormal skin window responses were present in 75% of the patients with myeloma, but only 22% of those with macroglobulinaemia. All the myeloma patients with anergy had abnormal skin windows but this correlation did not exist in macroglobulinaemia.

No correlation was found between the paraprotein concentration and anergy, PHA response or skin window.

The results support the conclusion that myeloma is predominantly associated with an abnormal skin window (inflammatory) response and macroglobulinaemia with intrinsic abnormalities of cellular immunity. When anergy and abnormal PHA response are present in myeloma, it appears to be attributable to an effect of the paraprotein and not an intrinsic abnormality of lymphocytes.
Histiocytic Medullary Reticulosis
Authors: Sullivan J. R. , Ungar B. , Hicks J. D. , Hurley T. H.
Published: March 2008

Summary: The clinical and pathological features of histiocytic medullary reticulosis (HMR) are described in five patients. Treatment by splenectomy and the MOPP routine resulted in a transient improvement in platelet and neutrophil counts and resolution of anaemia and apparent prolongation of survival in two of the five patients.

The relationship of HMR to other histiocytic disorders is discussed. HMR is defined as a unique malignant histiocytosis in which malignant histiocytes engage in phagocytosis of erythrocytes, leucocytes and platelets.
Serum Gastrin in Chinese Patients with Peptic Ulcer
Authors: Fung Wye‐Poh , Salmon J. A. , Tye C. Y. , Karim S. M. M. , Crawford I. C.
Published: March 2008

Summary: Serum gastrin in Chinese patients with peptic ulcer.
Inhaled and Oral Bronchodilator Therapy in Exercise Induced Asthma
Authors: Anderson Sandra D. , Rozea P. J. , Dolton R. , Lindsay D. A.
Published: March 2008

Summary: Inhaled and oral bronchodilatoi therapy in exercise induced asthma.
Rapid Correction of Water Intoxication by Hypertonic Saline and Frusemide
Authors: Worthley L. I. G.
Published: March 2008

Summary: Rapid correction of water intoxication by hypertonic saline and frusemide.
Diphenylhydantoin Sensitivity. A Syndrome Resembling Infectious Mononucleosis with a Morbilliform Rash and Cholestatic Hepatitis
Authors: Weedon A. P.
Published: March 2008

Summary: Diphenylhydantoin sensitivity. A syndrome resembling infectious mononucleosis with a morbilliform rash and cholestatic hepatitis.
A Family Study of Coeliac Disease
Authors: Shipman Richard T. , Williams Alan L. , Kay Rosa , Townley R. R. W.
Published: March 2008

Summary: Studies by Thompson1, Carter et al.2, MacDonald et al.3 and McCrae4 have all shown a high familial frequency of coeliac disease (CD). The diagnostic criteria differed in each study; in Thompson's patients the diagnosis was based on clinical or historical data alone; in Carter's study response to a gluten‐free diet was required, while in MacDonald's and McCrae's studies the diagnostic criteria included the demonstration of the lesion of CD by small bowel biopsy. In MacDonald's study some asymptomatic cases were discovered and a few of these had normal fat balance results. No hereditary pattern emerged from these studies though MacDonald postulated a dominant gene with variable penetrance while McCrae suggested that susceptibility to CD is inherited multifactorially and that environmental factors other than dietary gluten are of aetiological importance. Hoffman et al.5, on the other hand, have described discordance for CD in identical twins.
The Rate of Initiation of Treatment for Hypertension in a Community, 1971–1975
Authors: Lovell R. R. H. , Stephens W. B. , Thomson Lynda , Ulman R.
Published: March 2008

Summary: The rate of initiation of treatment for hypertension in a community, 1971–1975.

In 1971 persons aged 50–59 in a community were screened for hypertension and those with diastolic BP ≤ 110 mmHg were notified. On reviewing the sample in 1975 the treatment rate had doubled to 22%. Screening in 1971 was followed by an immediate rise in numbers starting treatment, most being notified cases. Thereafter initiation of treatment at a rate of 3–8 cases per 100 persons per year chiefly reflected identification of subjects deemed to need treatment in the ordinary course of medical practice. Of those starting treatment during the four years 25% had stopped it by 1975. The influence of screening and other factors on the rate of initiation of treatment and adherence to it are discussed. With an already high attendance rate at doctors, regular screening of this whole age group seems feasible within the framework of general practice. The high treatment rate found in 1975 underlines the urgent need for the indications currently used for starting treatment to be validated.
Murray Valley Encephalitis in Australia, 1974: Antibody Response in Cases and Community
Authors: Doherty R. L. , Carley J. G. , Filippich Cheryl , White J. , Gusttt I. D.
Published: March 2008

Summary: Murray Valley encephalitis in Australia, 1974: Antibody response in cases and community.

Fifty‐three patients accepted on clinical grounds as cases of Murray Valley encephalitis (MVE) in Australia in 1974 were examined for antibody to MVE virus. Only one (who died early in the disease and whose diagnosis was confirmed by virus isolation) did not develop antibody; 13 patients showed stationary or single convalescent titres not diagnostic of recent infection, but other evidence that infection was recent was obtained in eight; 39 showed significant rise or fall in titre confirming recent infection. Haemagglutination‐inhibition (HI) was more effective in establishing a diagnosis than complement‐fixation (CF) although both tests were of value. Patients varied widely in timing and magnitude of rise and fall of titre. Two showed late rises in antibody titre which raises the possibility of recrudescent persisting infection. CF titres were enhanced in some sera by increase in the number of units of antigen used and by inactivation at 56o C rather than 60oC.

Five patients with clinically‐acceptable diagnoses of MVE (and one with minor illness) showed higher HI titres to Kunjin than to MVE virus. The results in several cases suggest that Kunjin virus was the infecting agent. In others it is possible that MVE infection had occurred in patients with pre‐existing Kunjin antibody.

HI reactivity to MVE virus was found in IgM fractions of sera taken for at least 40 days and in some cases for over 100 days after onset of symptoms. IgM fractions gave similar titres to MVE and Alfuy virus but clearly distinguished MVE‐Alfuy and Kunjin viruses.

HI antibody to MVE virus was found in about 10% of sera from family contacts or neighbours of patients with encephalitis, and in a similar proportion of patients in Victoria with various febrile illnesses not accepted as MVE. One patient with minor illness had antibody response to Kunjin virus. 2589 sera from pathology laboratories in towns in the Murray Valley gave additional evidence of community immunity to f/aviviruses and suggested some increase in the proportion reactive between January and May 1974. HI and plaque reduction tests on these sera also gave evidence of antibody to Kunjin virus in the Murray Valley.
Thymus with B Lymphocytes in Chronic Lymphocytic Leukaemia
Authors: Adams P. B. , Cooper I. A.
Published: March 2008

Summary: Thymus with B lymphocytes in chronic lymphocytic leukaemia.

A 67‐year‐old man with a diagnosis of chronic lymphocytic leukaemia died suddenly following a coronary occlusion. Peripheral blood lymphocytes labelled with fluorescein conjugated polyvalent antisera to immunoglobulin and immunoglobulin G, and failed to label with absorbed anti‐thymocyte serum. At necropsy, a large thymic tumour, and enlarged mediastinal lymph nodes also contained immunoglobulin G bearing B lymphocytes. The paradoxical finding of B lymphocytes with monoclonal surface immunoglobulin in a thymic mass is most unusual in chronic lymphocytic leukaemia.
Chronic Granulomatous Hepatitis
Authors: Farrell G. C. , Powell L. W.
Published: March 2008

Summary: Chronic granulomatous hepatitis.

Three cases are described in which a chronic relapsing febrile illness was associated with granulomas in the liver. None of the known causes of hepatic granulomas was present in these patients. In two cases there was clinical improvement after corticosteroid treatment and this was associated with resolution of the histological changes on liver biopsy. These three cases support the concept that chronic granulomatous hepatitis of unknown aetiology is a distinct entity.
Intermittent Obstruction of the Upper Airway during Sleep Causing Profound Hypoxaemia. A Neglected Mechanism Exacerbating Chronic Respiratory Failure
Authors: Hensley M. J. , Read D. J. C.
Published: March 2008

Summary: Intermittent obstruction of the upper airway during sleep causing profound hypoxaemia. A neglected mechanism exacerbating chronic respiratory failure.

An obese patient with a ten year history of respiratory failure presented with insomnia and marked daytime somnolence. Respiratory failure had been attributed to obesity, respiratory centre insensitivity to carbon dioxide, and to diffuse airways obstruction.

To investigate the possible role of episodic apnoea with frequent nocturnal arousals, continuous recordings were obtained during sleep of arterial oxygen saturation, oesophageal pressure and the motions of the rib‐cage and abdomen/diaphragm.

Repeated episodes of hypoventilation and profound hypoxaemia were found which were due to intermittent obstruction of the upper airway rather than to cessation of breathing efforts. During the episodes of hypoxaemia, values of arterial 02 tension fell to as low as 24 mmHg. Episodic hypoxaemia was relieved but not abolished, by the use of a collar, designed to hold the mandible forward.

Previous reports indicated that recognition of intermittent obstruction of the upper airway during sleep and treatment by a permanent tracheostomy, resulted in a significant long‐term improvement of pulmonary and cardiac function and relief of insomnia and day‐time somnolence. When tracheostomy is inadvisable, as in the present patient, it is hoped that similar long‐term benefits will result from a supportive collar.
The Significance of Chest Pain Occurring with the Master Two Step Test
Authors: Jelinek V. M. , Herman M. V. , Schweitzer P. , Gorlin R.
Published: March 2008

Summary: The significance of chest pain occurring with the master two‐step test.
Recurrent Ventricular Tachycardia in Hypothyroidism
Authors: Lim Chin Hock , Lim Pin
Published: March 2008

Summary: Recurrent ventricular tachycardia in hypothyroidism.
Gangrene Following Intra‐arterial Injection of Procaine Penicillin
Authors: Sengupta S.
Published: March 2008

Summary: Gangrene following intra‐arterial injection of procaine penicillin.
The Epidemiologist's Contribution to Medical Care Planning and Evaluation
Authors: Florey C. du V. , Weddell J. M. , Leeder S. R.
Published: March 2008

Summary: The epidemiologist's contribution to medical care planning and evaluation.
Ventricular Visualization on the Brain Scan Associated with a Corpus Callosum Tumour
Authors: McKay W. J. , Andrews J. T.
Published: March 2008

Summary: Ventricular visualization on the brain scan associated with a corpus callosum tumour. W. J. McKay and J. T. Andrews, Aust. N.Z. J. Med., 1976, 6, pp. 149–152.

Ventricular visualization and a corpus callosum abnormality were diagnosed by brain scan and confirmed subsequently. Post mortem revealed an infiltrating microclimate impinging also on the floor of the lateral ventricle giving a naked eye appearance consistent with a granular inflammatory reaction of the ventricular surface.
Meliodosis Presenting as Encephalitis
Authors: Singh N.
Published: March 2008

Summary: Meliodosis presenting as encephalitis. N. Singh, Aust. N.Z. J. Med., 1976. 6, pp. 156–157.

Meliodosis is an infectious disease caused by Pseudomonas pseudomellei, an organism that is common in South‐East Asia, the Caribbean and northern Australia. In the author's case report the disease presented as an encephalitic illness with fever and epileptic fits in a five‐year‐old Chinese boy. The case illustrates one of the many forms of this illness. The patient though very ill, made an excellent recovery. The report discusses the manifestations, diagnosis and management of Meliodosis.
NON‐INVASIVE ASSESSMENT OF THE HEART IN THE HYPERTENSIVE
Authors: Wikstrand John , Berglund Göran , Wilhelmsen Lars , Wallentin Ingemar
Published: March 2008

The prevalence of signs of heart involvement was studied non‐invasively with orthogonal and conventional ECG, apexcardiogram, carotid pulse tracing and phonocardiogram in a group of untreated hypertensives (n = 35) and a reference group (n = 73). All were derived by screening a random population sample of 50‐year‐old men.
The Effects of Saralasin, an Angiotensin II Antagonist on Blood Pressure and the Renin‐Angiotensin‐Aldosterone System in Normal and Hypertensive Subjects
Authors: Brown J. J. , Brown W. C. B. , Fraser R. , Lever A. F. , Morton J. J. , Robertson J. I. S. , Rosei E. A. , Trust P. M.
Published: March 2008

Summary: The effects of saralasin, an angiotensin II antagonist, on blood pressure and the renin‐angiotensin‐aldosterone system in recumbent normal and hypertensive subjects.

Blood pressure reduction with saralasin infusion was seen only in hypertensive patients with abnormally elevated basal plasma renin and angiotensin II levels, and after sodium depletion the reduction in blood pressure was more marked. In normal subjects, and in hypertensives with plasma renin and angiotensin II levels within the normal range, there was no marked fall in blood pressure across saralasin infusion regardless of the sodium status of the individual.

Plasma aldosterone concentration fell during saralasin infusion in those subjects with high baseline renin and angiotensin II levels. This fall occurred in the sodium replete and deplete states. In the normal subjects, and those hypertensives with normal plasma renin levels, there was no fall in aldosterone in the sodium replete state. However, after sodium depletion the expected rise in aldosterone was abolished during saralasin infusion, the plasma aldosterone falling to within the normal sodium replete range, rising again after the saralasin infusion was stopped.

This study supports the concept of a direct role for renin and angiotensin II in the maintenance of hypertension in those subjects with elevated basal plasma renin. Plasma aldosterone would appear to be controlled, at least in part, by the prevailing plasma angiotensin II level in those subjects with elevated basal levels of angiotensin II; that is in high renin hypertensives, and in normal subjects and normal renin hypertensives who are sodium deplete.
Follow‐up of Renin in Essential Hypertension
Authors: Birkenhäger W. H. , Kho T. L. , Schalekamp M. A. , Zaal G. A. , Wester A. , de Leeuw P. W. , Vandongen R. , Fawzi‐Meininger T. D.
Published: March 2008

Summary: Follow‐up of renin in essential hypertension.

In a prospective study of patients with essential hypertension, plasma renin levels showed a progressive increase with longer follow‐up. This was associated with a parallel increase in renal vascular resistance. Arterial blood pressure and plasma volume did not change significantly during follow‐up. In patients where the hypertension was complicated by myocardial infarction there was a comparatively greater increase in renin levels and renal vascular resistance which may be attributable to chronic reduction of cardiac output.
Additive Effect of Beta‐Adrenergic Blockers in Combination with Vasodilators in Lowering Blood Pressure
Authors: Pettinger W. A. , Mitchell Helen C.
Published: March 2008

Summary: Additive effect of beta‐adrenergic blockers in combination with vasodilators in lowering blood pressure. W. A. Pettinger and Helen C. Mitchell, Aust. N.Z. J. Med., 1976, 6, pp.76–82

Complications of hypertension are by far the greatest preventable public health problem in many of the developed countries of the world. Pharmacologic interventions which primarily involve drug interactions are the generally available and effective means of preventing or delaying these hypertensive complications.

Mechanisms of beneficial antihypertensive drug interactions involve simultaneous reduction or control of blood volume (diuretic agents) and decrease of peripheral resistance. Reduction of peripheral resistance without producing intolerable side effects has recently been achieved by a complex drug interaction. This interaction involves simultaneous vasodilation and inhibition by beta‐adrenergic blocking agents of reflex activation of the renin‐angiotensin axis. Clonidine, by effects similar to propranolol, can substitute for propranolol in some patients, or add to the beneficial effects of this important drug interaction.
Blood Pressures and Electrocardiographic Findings in the South Australian Aborigines
Authors: Edwards F. M. , Wise P. H. , Thomas D. W. , Murchland J. B. , Craig R. J.
Published: March 2008

Summary: Blood pressures and electrocardiographic findings in the South Australian Aborigines. F. M. Edwards, P. H. Wise, D. W. Thomas, J. B. Murchland and R. J. Craig

Blood pressure measurements were recorded in 522 adults and 141 10–19 year‐old full and part blood Aborigines in five communities. The means for systolic and diastolic blood pressures at 40 years were close to those reported for Europeans, although below this age, values tended to be lower, and above 40 years tended to be higher than those reported in the Tecumseh study. Hypertension, as defined by the Princeton criteria, was present in 29%, more often in the men (1.6 to 1.0), and eight subjects satisfied the criteria for hypertensive heart disease (HHD).

522 electrocardiograms were recorded on adult subjects at five Aboriginal communities and classified according to categories of the Minnesota code. Of the 210 abnormalities observed, minor T wave inversions and minor S‐T segment depression were the most commonly encountered, and were more frequent in female subjects. Q wave changes typical of myocardial infarction was found in 5% of the tracings and occurred mainly in older men.

If hypertension and certain ECG codes are assumed to be “risk factors” for the development of clinical ischaemic heart disease (IHD), the urbanized Aboriginal had a higher prevalence compared with Caucasian subjects of the Busselton study.

“Probable” and “suspect” ECG changes of IHD, although mainly in the older subjects, were found to be associated with hyper‐glycaemia, as recognised in Western society. It is postulated that urbanized Aborigines are prone to cardiovascular degenerative disease to a similar or possibly larger extent than Caucasians.
Gastric Ulcer: Natural History and Treatment
Authors: Langman M. J. S.
Published: March 2008

Summary: The fragmentary knowledge of gastric ulcer aetiology is contrasted with the developing repertoire of short term drug treatments Reasons are also advanced for believing that gastric ulcer may be a disease of diminishing importance and that this is due to environmental changes rather than to the introduction of effective treatments.
Does Aspirin Play a Role in Analgesic Nephropathy?
Authors: Phillips B. M. , Hartnagel R. E. , Leeling J. L. , Gurtoo H. L.
Published: March 2008

Summary: Using a compound analgesic mixture, it was found that renal pathology could be produced in rats if the analgesic mixture was administered as a concentrated aqueous suspension, but that development of renal pathology was not favored by hot, dry environmental conditions. Determination of whole body total salicylate concentrations in rats and humans receiving various doses of aspirin revealed that twice daily doses of 24, 60 and 125 mg/kg aspirin in the rat were equivalent to human doses of 8, 20 and (approximately) 40 ordinary 325 mg aspirin tablets daily. These doses of aspirin were then employed in a subchronic study of the nephrotoxicity of aspirin in the rat using the experimental design which maximized the nephrotoxic effects of the compound analgesic mixture. Six groups of ten male and ten female rats received aspirin orally at doses of 24, 60 or 125 mg/kg twice a day five days a week for 12 weeks. Two additional groups of ten male and ten female rats received only the vehicle, at a volume equivalent to that received by the high dose group, and served as controls. Four groups (one each, control, low, mid‐, and high dose) were denied access to water for 16 hours daily overnight. No pathologic renal changes were observed in any of the rats. These findings are consistent with a growing body of evidence, from both animal and human studies, that aspirin alone does not produce analgesic nephropathy.
On the Continuing Education of the Physician*
Authors: Bogdonoff M. D.
Published: March 2008

Summary: On the continuing education of the physician. M. D. Bogdonoff, Aust. N.Z. J. Med., 1976, 6, pp. 509–513.
Recent Insights into Paroxysmal Supraventricular Tachycardia– An Integrated Approach to Diagnosis and Therapy
Authors: Wyndham C. R. , Meeran M. K. , Wu D. , Rosen K. M.
Published: March 2008

Summary: Paroxysmal supraventricular tachycardia may result from re‐entrance in the AV node, the norma/ A‐V pathway with an accessory AV connection, in the sino‐atrial node, in the atria, or else reflect ectopic impulse formation in a spontaneously automatic supraventricular focus. Electrocardiographic criteria which are helpful in differentiating these mechanisms involve an analysis of cycle length, changes in cycle length with intermittent bundle branch block, P wave morphology and the relationship of P wave to QRS complex, P‐R interval, the presence of A‐V block during tachycardia and the influence of autonomic tone on the tachycardia. Electrophysiologic studies further elucidate mechanism by demonstrating the mode of induction and termination of the tachycardia, the characteristics of antegrade and retrograde A‐V conduction curves and refractory periods, atrial activation sequence of echo beats and the influence of premature beats introduced during tachycardia. These features are summarised in Table 1. Therapy can be accurately planned according to the results of experimental administration of antiarrhythmic agents and of pacing sequences upon induction and termination of tachycardia in the catheterisation laboratory.
Insulin Aggravated Postural Hypotension
Authors: Palmer Karen T. , Perkins Christine J. , Smith R. B. W.
Published: March 2008

Summary: In a 76‐year‐old diabetic with symptomatic postural hypotension during the mornings, this was greatly improved by changing his time of insulin administration from 7.30 a.m. to 11.30 a.m.
The Treatment of Malignant Pericardial Effusion in Carcinoma of the Breast
Authors: Reynolds Patricia M. , Byrne M. J.
Published: March 2008

Summary: In three patients with metastatic carcinoma of the breast, control of a malignant pericardial effusion was achieved with a single pericardiocentesis followed by intensive systemic combination chemotherapy. No patient required reaspiration or any other form of local treatment.

A trial of this conservative initial approach is therefore recommended in patients with pericardial effusions due to breast carcinoma. Its use in those with other tumours likely to be sensitive to systemic chemotherapy warrants further evaluation.
Takayasu's Arteritis–A Study of 45 Cases
Authors: Samantray S. K.
Published: March 2008

Summary: Forty‐five cases of Takayasu's arteritis seen between January 1, 1960 and January 31, 1977 have been studied in terms of age and sex incidence, clinical features and results of various laboratory investigations. Although no definite aetiology has been established, the possibility of autoimmune process appears more likely than tuberculous or syphilitic aetiology.
Effects of Different Diuretics on Urinary Calcium Excretion in a General Population
Authors: Goulding A. , Spears G. F. S. , Simpson F. O.
Published: March 2008

Summary: Effects of different diuretics on urinary calcium excretion in a general population. A. Goulding, G. F. S. Spears and F 0. Simpson, Aust. N.Z. J. Med., 1978, 8, pp. 474–478.

Calcium excretion by users and non‐users of thiazide diuretics and frusemide was studied during a health survey. Men taking thiazides excreted less calcium than age‐ and weight‐matched controls. Both men and women taking thiazides excreted less calcium relative to sodium than controls.

Women taking thiazides excreted significantly less calcium than women taking frusemide. Both men and women taking thiazides excreted less calcium relative to creatinine than sex‐matched groups taking frusemide.
Polymyositis Presenting with Severe Weakness Involving Only One Arm
Authors: Stark R. J.
Published: March 2008

Summary: Polymyositis presenting with severe weakness involving only one arm. R. J. Stark, Aust. N.Z. J. Med., 1978, 8, pp. 544–546

A woman presented with severe weakness and wasting involving only one arm. A definite diagnosis was not made until almost six years later when she developed proximal weakness in the legs as well, and a muscle biopsy showed changes of polymyositis.

Asymmetry of weakness in polymyositis has been noted previously in the literature, but is rare. In previous reports asymmetry as marked as in the present case has not been noted.
Evaluation of Radiochromium Blood Loss Studies in Unexplained Iron‐Deficiency Anaemia
Authors: St. John D. J. B. , Young G. P.
Published: March 2008

Summary: Evaluation of radiochromium blood loss studies in unexplained iron‐deficiency anaemia

Radiochromium measurement of gastrointestinal (Gl) blood loss was performed on an outpatient basis on 57 patients with unexplained iron‐deficiency anaemia. With the exception of pre‐menopausal women, patients were only selected for study if the anaemia remained unexplained after careful Gl radiological and endoscopic examination. Occult Gl blood loss was confirmed in 31 patients and further investigation including laparotomy in some cases, led to a diagnosis in 17 of the 31. Carcinoma was present in five (colon four, stomach one) and benign lesions of the small intestine in five. There was no correlation between the severity or pattern of bleeding and the nature of the lesion. Of the 26 patients without demonstrable occult bleeding, anaemia was aspirin‐induced in five and caused by menorrhagia in six. With the pre‐menopausal women, measurement of both Gl and menstrual blood loss resulted in detection of silent Gl lesions in four and gynaecological disease in six. The cause of anaemia has not been elucidated in 23 of the 57 patients, including seven of 11 with aortic valve disease, even after follow‐up for an average of 30 years. These results indicate that radiochromium studies effectively identify the patients with unexplained iron‐deficiency anaemia who require continued active investigation for a focal Gl lesion.
Raynaud's Disease: Reduced Hand Blood Flows with Normal Blood Viscosity
Authors: McGrath M. A. , Peek R. , Penny R.
Published: March 2008

Summary: Raynaud's disease: Reduced hand blood flows with normal blood viscosity.

Hand blood flows and the blood and plasma viscosities were measured in patients with Raynaud's disease in an attempt to identify the mechanism of the episodic vascular insufficiency.

Using venous occlusion plethysmography the following observations were made: (1J the hand blood flows were significantly less than in normals at 32°, 27° and 20°C; (2) the percentage decrease in flow with cooling was greater than in normals and (3) cooling of one hand from 32° to 27°C caused an abnormal decrease in flow through the contralateral hand. Using a rotational viscometer the blood and plasma viscosities were found to be normal at both high and low shear rates. The percentage increase in the blood viscosity with cooling from 35° to 25° was also normal.

These studies demonstrate an increased constrictive response of the cutaneous vasculature of the hand to both local and reflex stimulation, and exclude a rheological abnormality, under conditions similar to those of the present study.
Early Diagnosis of Addison's Disease; Pigmentation as sole symptom
Authors: Strakosch C. R. , Gordon R. D.
Published: March 2008

Summary: Early diagnosis of Addison's disease; pigmentation as sole symptom.

A diagnosis of primary adrenocortical insufficiency was made in a shapely, suntanned girl whose sole complaint was increasing pigmentation. Plasma Cortisol was low in spite of markedly elevated levels of ACTH. Plasma Cortisol, urinary 17‐oxogenic steroids and urinary aldosterone did not respond to three days of ACTH stimulation. Addison's disease can be diagnosed and treated before development of anorexia, weight loss, weakness and other classical symptoms.
Hypertension Due to 17α‐Hydroxylase Deficiency
Authors: Wang C. , Yeung R. T. T. , Coghlan J. P. , Oddie C. J. , Scoggins B. A. , Stockigt J. R.
Published: March 2008

Summary: Hypertension due to 17α‐hydroxylase deficiency.

A female patient with hypertension, hypogonadism and hypokalemia due to 17α‐hydroxylase deficiency is described, in whom the diagnosis was initially based on the finding of low urinary 17‐ketosteroids and 17‐hydroxycorticosteroids, in the presence of high plasma f/uorometric 11‐hydroxy ‐corticoids. Later studies confirmed the diagnosis by demonstrating low circulating levels of 17u‐hydroxyprogesterone and the steroids derived from this precursor: 11‐deoxy‐cortisol, Cortisol, oestradiol and testosterone. Plasma progesterone, corticosterone and deoxycorticosterone (DOC) were greatly increased, but plasma and urine aldosterone were very low. The initial subnormal Cortisol and 11‐deoxyCortisol levels responded to tetracosactrin administration, suggesting that the adrenal was not maximally stimulated by endogenous ACTH and indicating that the 17α‐hydroxylase deficiency was incomplete. Plasma and urinary aldosterone levels were still suppressed after 12 months treatment with prednisone despite normalization of the previously suppressed renin levels. The findings indicate that this uncommon cause of medically‐controllable juvenile hypertension can be identified without specific steroid assays.
Clinico‐Laboratory Aspects of Anti‐Nuclear and Anti‐Native DIMA Antibody Tests
Authors: Webb John
Published: March 2008

Summary: Clinico‐laboratory aspects of anti‐nuclear and anti‐native DNA antibody tests. John Webb, Aust. N.Z. J. Med., 1978, 8, Suppl. 1, pp. 61–67.

Available techniques for detection of anti‐nuclear antibodies are here briefly reviewed. The relatively insensitive LE cell test has been largely supplanted by the indirect immunofluorescent ANA test which should be reported in terms of titre and pattern. Specific measurement of nDNA antibodies is now a regular technique in SLE diagnosis and management.
Effects of Anti‐Rheumatic Drugs on Immunological Parameters
Authors: Penny R.
Published: March 2008

Summary: Effects of anti‐rheumatic drugs on immunological parameters. R. Penny, Aust. N.Z. J. Med., 1978, 8, Suppl. 1, pp. 109–113.

A short review is presented of the immune and inflammatory sites of action of the more common agents in use by rheumatologists–in particular, corticosteroids, the non‐steroidal anti‐inflammatory and immunosuppressive drugs.
Scleroderma: Pathogenic Factors and Current Management
Authors: Penny R.
Published: March 2008

Summary: Scleroderma: Pathogenic factors and current management. R Penny, Aust. N.Z. J Med., 1978, 8, Suppl. 1, pp. 143–148.

The aetiology of scleroderma remains unknown. Pathogenetic mechanisms may originate from vascular, collagen or immune abnormalities. These are reviewed and the current management although in the main unsatisfactory may alleviate a number of the distressing symptoms.
A Controlled Trial of Cervical Manipulation for Migraine*
Authors: Parker G. B. , Tupling H. , Pryor D. S.
Published: March 2008

Summary: A controlled trial of cervical manipulation for migraine. G. B. Parker, H. Tupling and D. S. Pryor, Aust. N.Z. J. Med., 1978, 8, pp. 589–593.

The efficacy of cervical manipulation for migraine was evaluated. In a six‐month trial, 85 volunteers suffering from migraine were randomly allocated to three treatment groups. One group received cervical manipulation performed by a medical practitioner or by a physiotherapist, another received cervical manipulation performed by a chiropractor, while the control group received mobilization performed by a medical practitioner or by a physiotherapist. For the whole sample, migraine symptoms were significantly reduced. No difference in outcome was found between those who received cervical manipulation, performed by chiropractor or orthodox therapist, and those who received the control treatment. Chiropractic treatment was no more effective than the other two treatments in reducing frequency, duration or induced disability of migraine attacks, but chiropractic patients did report a greater reduction in pain associated with their attacks.
Labetalol: Bioavailability, Drug Plasma Levels, Plasma Renin and Catecholamines in Acute and Chronic Treatment of Resistant Hypertension
Authors: Louis W. J. , Christophidis N. , Brignell M. , Vijayasekaran V. , McNeil J. , Vajda F. J. E.
Published: March 2008

Summary: Labetalol: Bioavailability, drug plasma levels, plasma renin and catecholamines in acute and chronic treatment of resistant hypertension. W. J. Louis, N. Christophidis, M. Brignell, V. Vijayasekaran, J. McNeil and F. J. E. Vajda, Aust. N.Z. J. Med., 1978, 8, pp. 602–609.

The antihypertensive effects of labetalol have been studied in 30 patients with severe hypertension.

In seven of these patients acute administration was associated with falls in blood pressure which were maximal at two minutes, for intravenous injection and one hour for oral administration. The bioavailability of acute oral administration was studied and varied between 11 and 76%. There were no statistically significant changes in plasma renin and plasma catecholamines following acute administration.

In 30 patients labetalol was administered, usually together with a thiazide diuretic, on a chronic basis over a period of ten months. There was a significant relationship (r = 0–517, P & lt; 0001) between drug dosage and plasma levels and in four cases poor response could be attributed to low peak plasma levels of the drug. Improved blood pressure control was associated with a substantial reduction in the number and type of tablets patients were taking and an overall reduction in side effects. The commonest side effect was mild postural hypotension. In addition, one patient in the trial and another more recently have shown hyper‐reactivity to the drug and developed profound postural hypotension with the initial dose.

We conclude that labetalol when combined with a thiazide diuretic is an important therapeutic advance in the treatment of the difficult hypertensive subject.