bluuebunny/crossref_metadata_2025 huggingface dataset:
Adaptation to Underwater Distance Distortion as a Function of Different Sensory-Motor Tasks
Authors: Ono Hiroshi , O'Reilly Joseph P.
Published: January 2017

Adaptation to underwater distance distortion was investigated as a function of three sensory-motor tasks and exposure time. The tasks differed in terms of the extent to which visual feedback during the reaching response was provided. Eighteen experienced divers served as subjects. Each subject performed the three sensory-motor tasks and also observed another subject performing the tasks. Underwater distance perception was measured after each sensory-motor task and observing period. Adaptation occurred when the subjects performed the tasks but not when they were observing. The different sensory-motor tasks produced different amounts of adaptation. An argument is made that visually predirected reaching responses (no feedback) would produce greater adaptation than visually guided (feedback) reaching responses.
Training Transfer of a Formation Flight Trainer
Authors: Reid Gary B.
Published: January 2017

The present research was conducted to measure transfer of training from a formation simulator to aircraft formation flying. Evidence in support of positive transfer was obtained by comparing students trained in the formation simulator with students who were essentially untrained and with students trained in the aircraft. This design provided data for a direct comparison of five simulator sorties with two aircraft sorties, in an effort to establish quickly a training cost/transfer comparison. The results indicate that simulator training has at least the effectiveness of two aircraft sorties.
Human Factors in Romania
Authors: Seminara Joseph L.
Published: January 2017

A survey of Romanian ergonomics was conducted which included a review of ongoing research activities, visits to industrial plants, and a look at educational programs. Ergonomics in Romania is now emerging as a separate discipline. While still overshadowed by its older brothers, selection and training, there is considerable interest and activity in this relatively new field. The Romanians may well play a key role in helping to synthesize ergonomics efforts in the East and West by virtue of their unique geographical and political position.
The Influence of Motion and Audio Cues on Driver Performance in an Automobile Simulator
Authors: Mclane Robert C. , Wierwille Walter W.
Published: January 2017

A highway driving simulator with a computer-generated visual display, physical motion cues of roll, yaw, and lateral translation, and velocity-dependent sound/vibration cues was used to investigate the influence of these cues on driver performance.

Forty-eight student subjects were randomly allocated to six experimental groups. Each group of eight subjects experienced a unique combination of the motion and audio cues. The control group received a full simulation condition while each of the remaining five groups performed with certain combinations of motion and sound deleted. Each driver generated nine minutes of continuous data from which five performance measures were derived. Results indicate that the performance measures of yaw, lateral, and velocity deviation are significantly affected by the deletion of cues. In support of the hypothesis that driver performance is augmented by the addition of motion cues, statistically significant negative correlations were obtained between the number of motion cues present and the measures of yaw and lateral deviation. With respect to motion and audio cues, recommendations are made regarding simulator design criteria.
An Experimental Study of Driver and Pedestrian Interaction during the Crossing Conflict
Authors: Katz A. , Zaidel D. , Elgrishi A.
Published: January 2017

A controlled experiment was conducted to determine the relative importance of pedestrian, vehicle, and situational factors in influencing drivers to give way to crossing pedestrians. The following variables were combined in a complete factorial design: (1) type of crossing; (2) distance between oncoming vehicle and pedestrian; (3) orientation of pedestrian; (4) number of pedestrians; and (5) approach velocity of vehicle.

Trained pedestrians performed the start of an ordinary street crossing attempt and interacted with regular drivers whose response was measured in terms of changes in vehicle velocity. The experiment was replicated at two sites for a total of 960 crossing trials.

The results show that drivers slowed down, or stopped more, for crossing pedestrians when: (1) the approach speed of the vehicle was low; (2) the crossing took place on a marked crosswalk; (3) there was a relatively long distance between the vehicle and the pedestrian's point of entry into the road; (4) a group of pedestrians, rather than an individual, attempted to cross; and, (5) the pedestrian did not look at the approaching vehicle. Additionally, female drivers and older drivers slowed down more than other drivers.

Implications of the results for pedestrian safety, road design, and further research are discussed.
Ghosts of Kigali
Authors: Price-Smith Andrew T.
Published: January 2017

Beyond the enormous suffering of individuals and families, South Africans are beginning to understand the cost [of HIV/AIDS] in every sphere of society, observing with growing dismay its impact on the efforts of our new democracy to achieve the goals of reconstruction and development.
An Exploration of the Concept of Loneliness in Forensic Psychiatry
Authors: Murphy Denis
Published: January 2017

Subjective aspects of social support and loneliness were examined in a group of 30 forensic inpatients in secure units and were compared to a control group of 31 surgical inpatients. The secure-unit patients were more lonely and experienced the deficiencies in their social relationships in a different way to the controls. Loneliness for the secure-unit patients was a more unpleasant experience and more associated with difficulties in forming close attachments. There was a high correlation between loneliness and the personality trait of psychoticism in the secure-unit group which was not found in the controls. These results underline the serious problems of these patients with relationships and suggest the development of intervention programmes.
V. Fatal Hepatitis following Chlorpromazine
Authors: Johnson H. R. M. , Stern G. M.
Published: January 2017

The drug chlorpromazine, one of the so-called “tranquillisers,” is known to cause liver damage and transient jaundice but reports of fatal cases are rare. A case is reported of a woman of thirty-nine years who developed a fatal hepatitis following ten days' therapy with chlorpromazine.
Fatal Subarachnoid Haemorrhage Associated with Cervical Trauma
Authors: Cameron J. M. , Mant A. Keith
Published: January 2017

Four cases of death from traumatic vertebral artery haemorrhage have been described. In all cases death ensued rapidly after a blow to the side of the upper neck had been inflicted. High blood-alcohol levels were present in 2 of the cases recorded.
Seafood-Induced Fatal Anaphylaxis
Authors: Patel Freddy
Published: January 2017

Two cases of fatal anaphylaxis caused by seafood allergy are reported. The first serves as a reminder of the importance of obtaining a full medical history and details of the circumstances of death, and of the need to be aware of forensic post-mortem artefacts. Observations on the immunological mechanisms of type 1 or immediate hypersensitivity seen in the second case, and a discussion of preventive measures, offer subjects for medicolegal deliberation.
Routine Unselected Access to Day Case Electrical Cardioversion of Persistent Atrial Fibrillation: Anticoagulant Preparation is the Key Factor
Authors: Wilshire J , Smith A , Böhm A , MacFadyen R J
Published: January 2017

Objectives: To determine the routine efficacy of a day case cardioversion system operating in a remote geographical area with an unselected case referral base and a proportion of direct GP access. Design: Prospective analysis of all admitted cases in a 13 week period. Participants: 47 consecutive patients admitted for 49 planned episodes of electrical cardioversion. Measurements: Pre procedural investigations and preparation, immediate and three-month outcome of rhythm following ECV Results: We found a predominant use by the cardiac unit despite working within a general medical service unit suggesting low case selection from non-cardiac sources. We suspected and confirmed a high rate of point of care treatment cancellation. Poor management of anticoagulation was the dominant reason for canceling planned treatment. Procedural preparation in terms of anti arrhythmic drug therapy and investigations seemed well preserved. Conclusion: New strategies for initiating and sustaining adequate outpatient warfarin therapy are needed to allow such systems to operate efficiently.
Response of Metabolic Encephalopathy to Treatment with Cyanocobalamin
Authors: Bronte-Stewart J. , Chisholm I. A. , Lewis D. R. H.
Published: January 2017

A patient suffering from metabolic encephalopathy, tobacco amblyopia and a lung abscess is described.

The encephalopathy responded to treatment with cyanocobalamin but the tobacco amblyopia failed to improve until treatment with hydroxocobalamin was instituted. The significance of the findings on the possible role of cyanide absorption from the lung abscess is discussed.
Spina Bifida Cystica
Authors: Scott R. , Grant J. C.
Published: January 2017

One hundred and fifty patients with meningocele, myelomeningocele and myeloencephalocele treated in the 7 years, 1960–66, have been reviewed.

There were 24 meningoceles and 126 myelomeningoceles with a mortality of 4.2 per cent in the meningocele group and 57.9 per cent in the myelomeningocele group. Ninety one per cent of the deaths occurred in the first year of life.

The commonest causes of death are meningitis, hydrocephalus and pneumonia.

Of the 70 known survivors, 21 were in the meningocele group and 2 of them were handicapped. Forty nine were in the myelomingocele group and 32 have a degree of disability involving the lower limbs, the bladder or mental incapacity.
Plasma Insulin Studies in the Diagnosis of Insulinoma
Authors: McKiddie M. T. , Buchanan K. D. , Abernethy R. J.
Published: January 2017

Plasma insulin levels were measured in 8 patients of whom 5 were surgically proven to have, and 3 had strongly suggestive evidence of, a functioning islet cell tumour.

The fasting plasma insulin level was elevated in only 3 patients, despite repeated sampling.

The administration of tolbutamide produced an excessive insulin response in 5 of the 8 patients, glucagon produced an excessive insulin response in 4 of 6 patients tested, 1-leucine produced a rise in plasma insulin in 1 of 2 subjects tested and the only subject studied after 50g. oral glucose had a high insulin response. The insulin response was highest after tolbutamide in all but one patient and this would appear to be the single most valuable test. However false negatives may occur and therefore the whole range of tests may have to be performed to establish the diagnosis.

Two patients were studied during surgery and in one the insulin content of the tumour was assayed after extraction with acid alcohol.

Four patients were studied again after treatment by surgery (2) and diazoxide (2) when normal insulin levels were found.
Problems of an Electrocardiogram Reporting Service
Authors: Short David
Published: January 2017

One thousand consecutive electrocardiograms (E.C.Gs) of patients with suspected coronary disease recorded in the course of an E.C.G. Service for family doctors have been analysed against the background of the W.H.O. criteria for the diagnosis of myocardial infarction.

Five hundred and sixty seven tracings were abnormal, but only 63 showed conclusive evidence of myocardial infarction, and only six definite evidence that the infarction was recent.

Four hundred and thirty three E.C.Gs showed no definite abnormality, but for reasons which are given, coronary heart disease could not be excluded in these cases.

The family doctor requires an unequivocal answer to the question: Does this patient suffer from coronary heart disease? This analysis shows that the cardiologist with a single E.C.G. and a brief note before him can seldom give it.
The Hospital Clinical Unit
Authors: Longland C. J.
Published: January 2017

Some form of quite small Clinical Unit with its own wards has evolved in the larger Scottish hospitals as the best means of discharging the primary task of the hospital, namely caring for patients. Illness is a peculiarly individual matter demanding care by individual doctors and nurses and they can operate most effectively in this type of organisation, which also has advantages for teaching. Institutional medicine, however, is also concerned with much that is not directly concerned with treating patients; larger groupings, such as the Division, are necessary to cope with its requirements and in so doing should enhance the effectiveness of Clinical Units and relieve them of some administrative work.
Mortality among Psychiatric Patients
Authors: Innes G. , Millar W. M.
Published: January 2017

A 5-year follow-up study was carried out of all referrals to the psychiatric services in a Regional Board area. The death registers of the Registrar General for Scotland were searched for all patients who were not known to be alive at the end of the study.

Of the 2103 patients included in the original study, 343 were found to have died. This represents 15.9 per cent of males and 16.7 per cent of females referred. Most of the deaths (41%) occurred in the first year of follow-up, 20 per cent in the first 3 months.

The overall death rate was approximately twice the expectation based on death rates in the general population of the area. The excess was greatest in those aged under 55 years. All areas of residence, occupations and social classes had increased mortality.

Those patients diagnosed as organic psychosis had highest mortality (70%) but all diagnoses had an excessive number of deaths when standardised for age.

Of the initial referrals, 1.4 per cent committed suicide during the follow-up period. Apart from neoplasms where deaths were close to expectation, all other broad categories of causes of death were equally involved in the increase.

This survey of a total psychiatric referral group (in-patients, out-patients and domiciliary visits and private patients) supports previously reported studies, mainly of in-patients, in their finding of an association between high mortality rates and psychiatric illness. It is possible that this association may result from selective referral to the psychiatric services of those psychiatrically ill patients who exhibit physical symptomatology.
Colloid Carcinoma in the Anorectal Region
Authors: Tavadia H. B.
Published: January 2017

Two cases of colloid carcinoma of the ano-rectal region unassociated with carcinoma in the alimentary tract have been described. Histology from both cases showed the presence of non malignant mucin secreting glands as well as mucin secreting adeno-carcinoma. This supports the evidence put forward by Dukes and Galvin that the carcinoma originates from ectopic rectal mucosa.
Childhood Leukaemia in Scotland, 1939–68
Authors: Hems G. , Stuart Alice
Published: January 2017

Data from death certificates of 978 children who died from leukaemia in Scotland before their fifteenth birthday during 1939–68 were analysed. The main findings were the same as those reported for childhood leukaemia in England and Wales and the United States and were as follows: (1) Leukaemia mortality {principally lymphatic leukaemia) increased during the 1940's and 1950's with a slight decline during the 1960's; and (2) Mortality from lymphatic leukaemia rose to a peak at 3 to 4 years of age while mortality from myeloid and monocytic leukaemia was evenly distributed throughout the first 14 years of life.

Leukaemia mortality in Scotland was lower than for the majority of countries. During the 1950's the rate was the fifth lowest for males (35 per million) and seventh lowest for females (26 per million) of 25 countries.

There was no evidence of an urban-rural gradient or of seasonal variation of onset or mortality or of clustering of cases of leukaemia.

Regional variations in leukaemia mortality in Scotland were not significant in contrast to a significant regional variation in leukaemia mortality for adults in Scotland observed by Court Brown et al. (1960).
Echoencephalography—an Evaluation in General Medical Wards
Authors: Lindsay K. W.
Published: January 2017

Echoencephalography was performed on 80 patients with suspected intracranial pathology admitted to the medical unit of a general hospital. The accuracy of the technique in detecting the position of the midline structures, was found to be 91 per cent as confirmed in 32 patients by cerebral angiography, position of a calcified pineal body or by autopsy. The value of echoencephalography in the diagnosis of cerebro-vascular accidents and in the recognition of space occupying lesions is assessed. It is suggested that cerebro-vascular accident cases showing midline shift, should have further neurological investigation with a view to possible haematoma drainage. The presence of shift in patients with gradual onset of neurological signs and symptoms is considered strong evidence of a space occupying lesion.
Multiple Primary Neoplasms in the Western Hospital Region, Scotland: A Survey Based on Cancer Registration Data
Authors: Haddow A. J. , Boyd J. F. , Graham A. C.
Published: January 2017

A study of multiple primary neoplasms in the Western Hospital Region of Scotland {which covers about 3,000,000 inhabitants) has been carried out, using cancer registration data, for the period July 1958–66. The total registrations were 61,288. (1) After elimination of doubtful cases, 428 cases of multiple primary neoplasms remained for study, 0.73 per cent of the sample. (2) Multiple primaries occurred most commonly in people in whom the first malignant lesion appeared late in life. (3) In only a few sites did the relative prevalence of cancers in the multiple primaries (M.P.) series differ from that in the single primaries (S.P.) series. The incidence of bilateral breast cancer was less than 1 per cent. This figure is much lower than those reported by other workers. About half were cases of ‘simultaneous’ bilateral breast cancer, and of the others, about one quarter occurred within one year of discovery of the first neoplasm. Genital neoplasms were very common in the female M.P. series (40%), but in males, the M.P. and S.P. series showed identical prevalence of genital neoplasms. (4) Associations between pairs of cancers sufficiently pronounced to be statistically significant were few, occurring in 4 pairs of sites in males and in 5 in females. Skin cancers featured in all male and 2 of the female pairings, and genital cancers in three female pairings. (5) There was a very marked likelihood for cancers of the larynx, uterus (all types), bladder and skin to be the first primary to appear (70% of cases or over). (6) Almost one third of second primaries occurred within a year of the first and after this the number declined rapidly. This held good when the figures were related to the number of survivors and to the number of survival-months.
Termination of Pregnancy in the Unmarried
Authors: Briggs Eleanor M. , Mack Alison E.
Published: January 2017

During a 10-month period, 250 unmarried girls presented to the Glasgow Advisory Centre (G.A.C.), thinking that they were pregnant, and in 210 cases, pregnancy was confirmed. In 88 of these 210 girls, it was known that termination of the pregnancy was carried out, either in Glasgow or in England. Five girls were known to continue with the pregnancy, while the remaining 117 defaulted from further attendance and their outcome could not therefore be determined. Some of the problems associated with termination of pregnancy in the unmarried have been discussed including the workings of the Abortion Act, the role of the General Practitioner and the lack of facilities in the Glasgow area, both for the provision af advice and the performance of termination.
Inter-Laboratory Discrepancies in Serum Immunoglobulin Estimations
Authors: Ferguson Anne , Dick Heather M. , Fallon R. J. , Logan R. W. , Meudell Carolyn M.
Published: January 2017

In a collaborative study involving four hospital laboratories Immunoglobulins G, A and M were assayed in 12 human serum specimens. The aims were to define the magnitude of inter-laboratory discrepancies in the values obtained, to identify likely reasons for these discrepancies, and to ascertain whether they were reduced when Immunoglobulins were assayed by comparison with a British Standard preparation.

The results of this experiment emphasise the importance of continuing experience in Immunoglobulin assay techniques; there may be considerable variation in the results obtained when the same specimen is tested in different laboratories, or at different times in one laboratory; these discrepancies are reduced if laboratories use reagents from the same source (commercial sources in this case).

When the usual laboratory Immunoglobulin standards were replaced by a British Standard preparation, there was no improvement in the results for IgG and IgA assays, but inter-laboratory variation in IgM measurements was significantly reduced.
A Prospective Study of the Persistence of Mycoplasma Pneumoniae Antibody Levels
Authors: Jones G. R. , Stewart Sheila M.
Published: January 2017

Sera from 13 patients with initial complement fixation (CF) titres of 160 or above, and from 5 with rising titres to Mycoplasma pneumoniae were tested at 2-monthly intervals for CF antibodies and for cold agglutinins. In an attempt to differentiate between ‘early’ and ‘late’ sera with raised titres, initial sera and those, taken 6 to 8 months later, with a CF titre of 160 or above were tested by the metabolic inhibition test and also treated with 2-mercaptoethanol (2ME).

Cold agglutinins were detected in 5 of the 13 initial sera but in none of the 7 ‘late’ sera with raised CF titres. A 4-fold or greater fall in the CF titre after treatment with 2ME occurred in 5 of the 12 initial sera tested, and in one of the 7 ‘late’ sera. Metabolic inhibiting antibodies were present in 7 of the 12 initial sera and in 4 of the 6 ‘late’ sera tested. In only one patient with a raised initial CF titre but no cold agglutinins and no 2ME effect was there later evidence of a current infection with M. pneumoniae. Cold agglutinins were present and/or there was a 2ME effect in the initial sera from all 5 patients with rising titres.

It is concluded that a combination of cold agglutinins and the effect of 2ME on the CF titres will help to differentiate ‘early’ from ‘late’ sera with significantly raised CF antibodies.
The Functional Role of Intravascular Coagulation in Renal Disease
Authors: Wardle E. Nigel
Published: January 2017

There is evidence of intravascular coagulation in accelerated hypertension and pre-eclamptic toxaemia, in all types of nephritis and in the haemolytic-uraemia syndrome. The kidneys have a two-fold defence mechanism, namely mesangial cell phagocytosis and endothelial cell fibrinolytic activity. Intravascular coagulation occurs in all those types of shock that result in acute renal failure: more often than not the primary cause is endotoxinaemia.
The Natural History of Bacterial Colonization of the Newborn in a Maternity Hospital (Part II)
Authors: Kerr M. M. , Hutchison J. H. , MacVicar J. , Givan J. , McAllister T. A.
Published: January 2017

The object of this study was to determine the sources from which the newborn infant derives his bacterial flora during the first 5 days after birth. Detailed bacteriological data was obtained from 193 mothers antenatally and during labour, and from their infants on the day of birth and on Day 5. Organisms were typed by appropriate methods and the 193 mother-baby pairs declared to be a ‘match’ or a ‘non-match’ according as to whether or not identical bacteria were isolated from both members of the pair. Weekly swabs from hands and noses of staff were taken throughout the 12 months of the study. Swabs were also taken from the environment and air samples from different areas in the hospital.

In approximately one third of infants the colonizing bacteria are derived from their mothers, in over 70 per cent of instances from the mother's rectum. The mother's birth canal is not a common source of bacteria and there is no direct relationship with the noses or hands of staff. Artificial feeds are not a source of the colonizing bacteria. The overall distribution of the bacterial species in the infants differed from that found in the hospital environment but this does, none the less, constitute a reservoir of bacteria which is being continually replenished from human sources. Pathogens such as Staph. aureus and Strep. pyogenes are no longer commonly found in newborn infants in the modern maternity hospital, but the need for continual vigilance and an efficient bacteriological service in all maternity units has been in no way diminished.
Mode of Action of Beta Blockers in Angina Pectoris
Authors: Åblad B. , Carlsson E. , Ek L. , Johnsson G.
Published: January 2017

Research Laboratories, AB Hässle, Fack, S-431 20 Mölndal, Sweden

The therapeutic effect of beta adrenoceptor blockers in angina pectoris can be ascribed to an inhibition of β1 receptor mediated stimulation of heart rate and myocardial contractility, resulting in an improved oxygen supply-demand balance in the myocardium.

When given in equipotent β1 blocking doses, the nonselective blocker propranolol and the β1 selective blocker metoprolol differ markedly as regards inhibition of adrenaline induced β2 mediated vasodilatation. Only propranolol will inhibit this effect. After propranolol, adrenaline therefore elicits a haemodynamic effect pattern characterized by high peripheral vascular resistance, high arterial blood pressure, low cardiac output and increased cardiac size. In view of these findings it is suggested that a β1 selective blocker may be a more efficient antianginal agent than a nonselective blocker in those patients in which the anginal attack is associated with a significant release of adrenaline. The clinical relevance of this hypothesis has not been tested.
Serum Protein Analysis and Bone Marrow Cytology in Patients with an Extreme Elevation of the Erythrocyte Sedimentation Rate
Authors: Ford M. J. , Parrish Frances M. , Innes J. A. , Webber R. G. , Allan N. C. , Horn D. B. , Munro J. F.
Published: January 2017

One hundred patients in whom an Erythrocyte Sedimentation Rate(ESR) in excess of 100 mm. in the first hour was found on 2 consecutive occasions were investigated. Serum protein electrophoresis was performed on 96 of these patients and bone marrow examination on 55 patients. Acute infection was the commonest diagnosis though the majority of patients had 2 or more separate conditions each contributing to the elevation of the ESR. Quantitive serum protein electrophoresis was abnormal in all but one patient and was of limited diagnostic value. A definite band in the globulin region was detected in 11 patients, 7 of whom were found to have myelomatosis. Bone marrow examination was useful only in patients with a discrete band in the globulin fraction or with a specific haematological abnormality. It is suggested, therefore, that bone marrow examination be confined to patients with such abnormalities irrespective of an elevation of their ESR.
Severe Fat Embolism: A Review of 24 Cases
Authors: Wildsmith J. A. W. , Masson A. H. B.
Published: January 2017

Twenty-four patients suffering from fat embolism syndrome, severe enough to warrant transfer to an artificial ventilation unit, are reviewed. All developed the condition following trauma. Five patients were managed with oxygen therapy and sedation, but the other 19 needed intubation and ventilation to achieve adequate arterial oxygenation. In spite of intensive supportive therapy, 6 patients (who had all required ventilation) died, one due to heparin therapy, the others from progression of the syndrome. A poor prognosis seemed to be associated with young age, a rapidly progressive condition and a continued need for 100 per cent oxygen after institution of artificial ventilation. There seemed to be no relationship between outcome and severity of injury, type of surgical management and time of onset after injury. The clinical features of these patients are discussed with reference to the many unanswered questions that surround this condition.
Temporal Arteritis
Authors: Jonasson F. , Cullen J. F. , Elton R. A.
Published: January 2017

A total of 136 patients with histologically proven temporal arteritis were seen in the Lothian Region of Scotland in the 14-year period, 1964–77. This study is a review of these cases with particular reference to incidence, age, sex, seasonal occurrence, along with clinical features, general and visual prognosis. It also comments on treatment, the adverse effects thereof, and the differential diagnosis. A seasonal effect significant at the 1 per cent level was established with a peak occurrence in January.
Antibacterial Prophylaxis–A Clinician's View
Authors: Gray J. A.
Published: January 2017

The principles of antibacterial prophylaxis and its advantages and disadvantages are reviewed. Controlled trials have shown chemoprophylaxis to be beneficial notably in preventing recurrences of rheumatic carditis and urinary infections and in controlling sepsis after cardiac and hip joint surgery and mid thigh amputations. The recently introduced metronidazole prophylaxis for gastrointestinal and gynaecological operations appears highly effective. The use of prophylaxis is briefly discussed in other situations where its value is less certain or where, in the author's opinion, it is contraindicated.
Acute Reactions to Mega Ascorbic Acid Therapy in Malignant Disease
Authors: Campbell Allan , Jack Thomas
Published: January 2017

Three cases are described, 2 of Hodgkin's disease and a further case of bronchial carcinoma, where high dosage ascorbic acid treatment appeared to be associated with the development of potentially dangerous symptoms. It is suggested that mega ascorbic acid therapy should be given with caution in malignant disease, with a slow build-up over several days to high levels of dosage.
Ectopic Hormone Production by Tumours
Authors: Bewsher P. D.
Published: January 2017

The ectopic production of hormones by tumours is important to appreciate as relevant endocrine features may antedate the appearance of other evidence of the tumour. This possibility should be borne in mind particularly when considering Cushing's syndrome, excessive ADH production or hypercalcaemia and could result in many instances in a quite different approach to further investigation and management. Carcinoma of lung is the commonest underlying neoplasm in several such situations but there are some, such as the hypoglycaemic syndromes, in which the tumour may even be benign.
Oestrogens and Breast Cancer: Present Position
Authors: Hawkins R. A.
Published: January 2017

Oestrogen is probably involved in breast cancer in two main ways: (1) in the aetiology of the disease as a promoting substance rather than as a carcinogen; (2) in stimulating the growth of at least some established breast cancers, acting through the oestrogen receptor.

Successful modes of endocrine therapy would then be interpreted as interfering with (a) the supply of oestrogen to the tumour (b) the nuclear events in oestrogen action or (c) receptor replenishment.
Scanning Electron Microscopy and Resin Histology of Large Bowel Biopsies
Authors: Carr Katherine E. , Wong A. L. , Young D. G. , Toner P. G. , Watt Chistine
Published: January 2017

The mucosal surface of human colon in 18 adults and children was examined by S.E.M. with subsequent resin histology and transmission electron microscopy of the same specimen. Results showed that this technique contributed useful information on the mucosa in health and in disease.
Prevention of Deep Vein Thrombosis in Medical Patients by Low-Dose Heparin
Authors: Belch Jill J. , Lowe G. D. O. , Ward Agnes G. , Forbes C. D. , Prentice C. R. M.
Published: January 2017

A randomised trial was undertaken in one hundred patients with heart failure and/or chest infection to determine whether low-dose subcutaneous heparin reduced the frequency of deep vein thrombosis (DVT) in the legs. Heparin, (5000 units 8 hourly) significantly reduced the frequency of DVT, diagnosed by the125I-fibrinogen scan technique, from 26 to 4 per cent (p < 0.01). Heparin was started within 12 hours of admission to hospital and continued until the patient was fully mobile. Heparin did not cause bleeding problems except for a 20 per cent incidence of injection site bruising. We therefore recommend prophylaxis with low-dose subcutaneous heparin in patients with heart failure or chest infection who require more than three days bed rest.
45 Years with Dalziel's (Crohn's) Disease
Authors: Quigley E. M. , Mills P. R. , Watkinson G.
Published: January 2017

A patient with chronic regional enteritis, diagnosed in Glasgow in 1935 who has now survived for 45 years despite nine operations and the development of multiple nutritional and post-surgical complications is described. Her case history, one of the longest in the literature provides a unique record of the course of this disease and of the consequences of surgical intervention.
Home Parenteral Nutrition: The First Twelve Months
Authors: Pennington C. R. , Ritchie Patricia H. , Pringle R.
Published: January 2017

A patient was treated by home parenteral nutrition because of alimentary failure due to active Crohn's disease, enterocutaneous fistulae, and the short bowel syndrome following massive intestinal resection. This therapy has now been continued for twelve months during which her symptoms, weight, and quality of life have all improved. Complications included an episode of Staph. Albus bacteraemia, and displacement of the replacement catheter. Hepatic steatosis due to excessive dextrose administration because of apparent allergy to Intralipid constitutes an unresolved problem.
Radiation under Phototherapy and its Relationship to Clinical Effectiveness in Moderately Severe Neonatal Jaundice
Authors: Smith I. J. , Wright D. H. , Keay A. J.
Published: January 2017

Radiation under four commercially available phototherapy units was measured over the visual spectrum and demonstrated that between 69 and 87per cent of the radiation was irrelevant to the photodegradation of bilirubin. When infants with moderately severe physiological jaundice were exposed to three of the same phototherapy units under the same conditions there was no demonstrable difference in the apparent rate of decline of serum bilirubin or in length of treatment required.
Perinatal Paroxysmal Supraventricular Tachycardia
Authors: McCune G. S.
Published: January 2017

Three cases of perinatal paroxysmal supraventricular tachycardia are described. In two patients the tachycardia was present prior to delivery; in the third baby, who also had the Wolf-Parkinson-White Syndrome, the time of onset of tachycardia is not known. The risks of this condition to the foetus are largely unknown but severe intra-uterine cardiac failure can occur. Possible lines of management are discussed.
Acute Haematogenous Osteitis—A Ten Year Review
Authors: Caullay J. M. , Mann T. S.
Published: January 2017

Sixty-four cases of acute haematogenous osteitis have been reviewed. The majority of these patients have been treated by high dose intravenous bolus injection of Cloxacillin. With this regime a primary healing rate of 96.8 per cent was achieved with a surgical intervention rate of 4.6per cent. It is concluded that routine surgery is not required in the treatment of this condition and that the mainstay of treatment should be vigorous antibiotic therapy.
Transpyloric Feeding in the Newborn: Use in Neonates with and without Respiratory Failure
Authors: Mulla M. , Mitchell I.
Published: January 2017

In a peripheral maternity hospital providing Intensive Care for 5274 deliveries per annum, NJ feeding was attempted, in one year, in 57 neonates. One third of these weighed less than 1500 g at birth and 41 (71.9%) had respiratory disease. A standard technique, and a commercially available tube was used, and the tube was passed to the jejunum within 24 hours in 46 (80.7%) of the babies. NJ feeding was continued for varying periods, up to 50 days. The volume of milk given varied with the duration of the feed but feeds of up to 244 ml of milk/Kg body weight/day were achieved. Thirty-eight (66.6%) of the babies regained their birthweight by 20 days and major complications were uncommon. We have shown that NJ feeding can be used in low birthweight babies with serious respiratory illness, even when resources are limited.
Pulmonary Sarcoidosis after Ten to Twenty Years
Authors: Johnston R. N.
Published: January 2017

One hundred and fifty-nine patients with Pulmonary Sarcoidosis have been studied ten to 20 years after diagnosis with a 90 per cent follow-up of survivors. Among the 76 patients with a mean follow-up of 22.5 years there is radiological evidence of pulmonary fibrosis in 13 and respiratory function tests revealed 12 with a transfer factor of less than 80 per cent of predicted. Of the further 83 patients followed to ten years there was radiological evidence of pulmonary fibrosis in five and a reduced transfer factor in four. Thirty-one patients received Prednisolone for various complications due to Sarcoidosis. There is no evidence of late respiratory disability. The complications and causes of death at ten and 20 years are examined and among the latter eight developed various forms of malignant disease. Since 1973 a further 139 patients have been studied, i.e. a total of 298 and two of these died from progressive Sarcoidosis despite corticostroid treatment. Six patients have developed late autoimmune diseases.
Resectable Colonic Carcinoma—A Five Year Experience
Authors: ur Rehman Bashir , Abdul-Amir-Al-Dawood  , Busuttil A. , Small W.P.
Published: January 2017

Clinical characteristics, mode of presentation and pathological features of resectable carcinoma of the colon have been studied in 224 cases presenting between January 1971 and December 1975. Minimum length of follow-up is five years and is complete. Forty-three per cent of patients survived five years or more, only 23 per cent of tumours being early in histological terms. The conventional high risk groups contributed little to the total and their active surveillance will not significantly improve the overall statistics.
A Critical Appraisal of a Rapid Radiographic Method of Determining Total Lung Capacity
Authors: Teklu B. , Gray W.M. , Mills R.J. , Moran F.
Published: January 2017

We have demonstrated that the total lung capacities of normal Caucasian adults, can be satisfactorily estimated by means of a regression equation derived from a single set of three measurements taken from a specially exposed plain X-ray film of the chest. However, these equations differ from those found by workers who have studied patients with lung disease. It is concluded from this that different regression equations are to be expected for normal and diseased lungs, and that, the appropriate equation will depend not only on the presence of disease, but also on its type and severity. It is also concluded that the rapid radiographic method of estimating total lung capacity can make little contribution to the diagnostic assessment of lung disease. However, the regression equations appropriate to particular ethnic groups could be used to measure TLC in normal subjects rapidly and inexpensively in places where specialised respiratory equipment and trained personnel are lacking.
Bowel Adenocarcinoma in a Patient with Cystic Fibrosis
Authors: Roberts J.A. , Tullett W.M. , Thomas J. StJ. , Galloway D. , Stack B.H.R.
Published: January 2017

Cystic fibrosis (CF) is an autosomal recessive condition affecting one in 2,000 live births in the UK. There are few reports of malignant tumours in this condition probably because, until recently, the majority died before the age of 30 years as a result of recurrent and chronic bronchopulmonary infection with impaired growth and development and resistance to infection due to pancreatic malabsorption. We describe an adult male with CF who died from an adenocarcinoma affecting the ileocaecal region of the bowel.
Addison's Disease without Pigmentation
Authors: Runcie C.J. , Semple C.G. , Slater S.D.
Published: January 2017

Four cases of Addison's disease are described in whom the diagnosis was unexpected or dangerously delayed because of the absence of pigmentation.
Thrombocytopaenia as the Presenting Feature of Persistent Generalised Lymphadenopathy (PGL) in a One Year Old
Authors: Forsyth J. S. , Sharp R. A. , Ghosh S.
Published: January 2017

A one-year-old child who presented with thrombocytopaenia was found to be HIV positive and has, now developed persistent generalised lymphadenopathy (PGL).
Long Term Amantadine Treatment the Danger of Withdrawal
Authors: Wilson J A. , Farquhar D.L. , Primrose W.R. , Smith R.G.
Published: January 2017

Three elderly Parkinsonian patients on long term amantadine therapy (mean nine years) are presented. In each case abrupt withdrawal of amantadine resulted in rapid deterioration in the patient's condition which was corrected by reintroduction of amantadine.
Familial Primary Biliary Cirrhosis and Autoimmune Thrombocytopenia
Authors: Chalmers E.A. , Lam D. Chan , Holden R. J. , Fitzimons E. J.
Published: January 2017

Primary biliary cirrhosis (PBC) is described in two sisters, one of whom presented with autoimmune thrombocytopenia. Taken together with reports of platelet autoantibodies in PBC this case may indicate a place for immunosuppressive agents in the treatment of thrombocytopenia in PBC.
Tolerance of Scottish National Blood Transfusion Service Intravenous Immunoglobulin in Patients with Primary Hypogammaglobulinaemia: Report of 1235 Infusions
Authors: Leen C.L.S. , Yap P.L. , Williams P.E. , McClelland D.B.L.
Published: January 2017

A total of 1235 immunoglobulin infusions were carried out as replacement therapy in 37 patients suffering from primary hypogammaglobulinemia from 1983 to 1987, using Scottish National Blood Transfusion Service (SNBTS) IV IgG, manufactured by cold ethanol fractionation of plasma, ultrafiltration and mild pepsin proteolysis at pH4. Ten patients experienced adverse reactions during 34 infusions (2.8% of all infusions) and all but five were mild; 21 (62%) of the adverse reactions were encountered in the patients' first five infusions. A maximum immunoglobulin infusion rate of 5 mg/kg/min was tolerated without adverse reaction.
Pseudomembranous Colitis in Association with Henoch Schonlein Purpura
Authors: Narchi H. , Beattie T. J. , Taylor R. G. , Evans T. J. , Azmy A. F.
Published: January 2017

We describe the occurrence of antibiotic-associated pseudomembranous colitis in two cases of Henoch Schonlein purpura. We discuss the potential diagnostic difficulties and suggest that Henoch Schonlein purpura may predispose to the development of antibiotic-associated pseudomembranous colitis.
Lyme Disease in the Highlands
Authors: Ho-Yen D. , Bennet A.J. , Chisholm S. , Deacon AG
Published: January 2017

Serological results for Borrelia burgdorferi were examined for one year. The results suggest a ‘pocket’ of infection in one Highland general practice. In this practice, most of the patients had exposure to tick bites and rashes were frequent. There were difficulties in relating serological results to clinical features and management of some patients.
Long-Term Weight Changes in Treated Hyperthyroid and Hypothyroid Patients
Authors: Pears J. , Jung R. T. , Gunn A.
Published: January 2017

To compare the effect of three treatments for thyrotoxicosis on subsequent body weight, a retrospective survey of 65 patients was performed. The effect of thyroxine replacement on body weight in 25 patients with primary hypothyroidism was also examined. In one year after starting therapy 21 patients treated with carbimazole gained a mean of 5.4kg (95% confidence interval 3.6 to 7.2kg); 20 patients after thyroidectomy gained a mean of 6.3kg (95% c.i. 3.4 to 9.2kg); and 24 patients given radioiodine gained a mean of 7.4kg (95% c.i. 5.2 to 9.6kg), p<0.001 in all three groups. The weight gain in the three groups was not significantly different. 54–67% of the weight gain occurred in the first three months. The patients treated for hypothyroidism had lost an insignificant amount of weight 12 months after starting therapy — Mean change was −0.6kg (95% c.i. −2.2 to +1.1kg) p>0.1.

This data suggests that all patients treated for thyrotoxicosis will gain body weight irrespective of the treatment used, but patients treated for primary hypothyroidism will not lose an appreciable amount of weight. Therefore dietary advice should be given, where appropriate, at the onset of any treatment of thyroid dysfunction.
Who Requests Reversal of Female Sterilisation?: A Retrospective Study from a Scottish Unit
Authors: Ramsay I.N. , Russell S.A.
Published: January 2017

The characteristics and circumstances of 55 women who underwent reversal of sterilisation were compared with those of 55 women who had a sterilisation performed at the same time, but who did not subsequently undergo reversal. Patients who underwent reversal were sterilised at a significantly younger age, and were more likely to have been sterilised at the time of therapeutic abortion or miscarriage. The parity at the time of sterilisation was the same for both groups. The reason for requesting reversal was a change of partner in the vast majority of cases. From this and other studies we conclude that alternative contraception should be sought in patients who are young or whose relationships appear unsteady at the time of sterilisation request, and that sterilisation at the time of therapeutic abortion should be abandoned in favour of an interval procedure. By so doing we may stem the rising tide of patients who subsequently seek a reversal of their sterilisation.
AIDS-Related Attitudes and Knowledge among Attendees at a Scottish Family Planning Clinic
Authors: Barbour R.S. , Macintyre S. , McIlwaine G. , Wilson E.
Published: January 2017

AIDS-related attitudes and knowledge of 1,970 family planning clinic attenders were examined using a self-completion questionnaire. Attitudes towards testing varied depending on the sex, age and marital status of respondents. Knowledge of HIV transmission routes was generally good, although the fact that those most likely to be at risk of infection — The younger respondents and those not currently in steady relationships — Were the least well-informed gives some cause for concern. Since family planning consultations are frequently the only contact these young sexually active individuals have with the health service the opportunities for health education on HIV/AIDS afforded by regular attendance at these clinics should be capitalized upon.
Pneumocystis Carinii Pneumonia in Thymoma with Hypogammaglobulinaemia: Successful Outcome of Therapy Including IV IgG Replacement
Authors: Mackenzie S.J. , Williams P.E. , Rajagopalan N. , Grant I.S. , Petrie G.R. , Burns S.M. , Yap P.L.
Published: January 2017

A 66-year-old patient presented with Pneumocystis carinii Pneumonia (PCP) and was found to have hypogammaglobulinemia, associated with a thymoma that had been resected 17 months earlier. Only one previous case of PCP in association with a thymoma and hypogammaglobulinemia has been reported, in which the patient died. We report another such patient who was successfully treated with a combination of intravenous immunoglobulin and high dose cotrimoxazole.