bluuebunny/crossref_metadata_2025 huggingface dataset:
THE DIAGNOSIS AND TREATMENT OF ADDISON'S DISEASE
Authors: HUDSON BRYAN
Published: September 2017

Experience with 21 patients suffering from Addison's disease is described. Twenty patients are alive and able to lead active and normal lives. One patient died in Addisonian crisis at the time of diagnosis. The presenting symptoms and signs of the patients have been analysed.

These patients have been drawn from a larger series of 41 cases in which the diagnosis of adrenal insufficiency was suspected. The conditions with which Addison's disease is commonly confused include : states of malabsorption, occult malignant disease, chronic renal disease, anorexia nervosa, other anxiety states, and orthostatic hypotension.

Recent laboratory procedures have simplified the problems of differential diagnosis. The value of various diagnostic investigations is discussed, and the need for ACTH stimulation in diagnosis is stressed. Examples are cited of the application of the different procedures in diagnosis to patients in this series.

An analysis has been made of the cause of the disease. This shows that the incidence of tuberculosis has become conspicuously less.

Treatment of patients is outlined and discussed. All patients have been successfully maintained on cortisone or hydrocortisone for periods of up to six years. Eight patients receive mineralocorticoid supplement.

It is concluded that the outlook for the patient with Addison's disease has improved with the introduction of newer methods for diagnosis, particularly ACTH stimulation, and with the availability of cortisone or hydrocortisone for treatment.
THE PHONOCARDIOGRAM IN CONGENITAL HEART DISEASE
Authors: GARDINER M.
Published: September 2017

Phonocardiograms recorded in a series of 440 cases of congenital heart disease have been analysed, and the patterns found in the chief conditions described. These patterns are typical in the great majority of cases, and a well‐taken phonocardiogram, while a relatively simple test, will greatly assist in establishing the diagnosis. It may also give a good indication of the severity of the lesion, and of the presence of associated physiological disturbances, such as pulmonary hypertension. Records of diagnostic value may be obtained even in infancy.

Phonocardiography serves to make clinical auscultation more precise, so that the maximum amount of information may be obtained from it. It also provides a permanent record of heart sounds and murmurs, which assists in following the progress of patients. It is a valuable adjunct in the study of congenital heart disease.
CLINICO‐PATHOLOGICAL FEATURES OF ACUTE HÆMORRHAGIC LEUCOENCEPHALITIS
Authors: VANDERFIELD G. K. , TOMPKINS MARION , JELIHOVSKY TATIANA
Published: September 2017

Three cases of acute hæmorrhagic leucoencephalitis are described; the patients were admitted to the one hospital over a period of three months. All cases were associated with an acute respiratory illness.

As these cases presented a definite clinical syndrome, with headache, scattered cerebral signs and sterile cerebro‐spinal fluid containing polymorphs, it is our view that in future cases, once cerebral abscess has been excluded, it may well be possible to establish a diagnosis during life and to institute therapy.
THE CASUAL ARTERIAL PRESSURE OF FIJIANS AND INDIANS IN FIJI
Authors: LOVELL R. R. H. , MADDOCKS I. , ROGERSON G. W.
Published: September 2017

Casual arterial blood pressure has been measured in population samples of Fijians and Indians inhabiting Fiji.

Certain features of blood pressure found in peoples of Europe and America have been found in both races. The means and standard deviations of systolic pressures rise with age. The means of diastolic pressures rise, at least to the sixth decade. Pressures rise more in females than in males. Frequency distributions of pressures are continuous and mostly show positive skewness. Each race contains subjects with markedly raised pressures.

The overall mean systolic and diastolic pressures of Fijians and Indians are similar, but pressures rise more with age in Indians than in Fijians. Differences between races in the younger groups are reduced when differences in arm circumference are taken into account. Correction for arm circumference increases the relatively higher pressures of elderly Indians.

The levels of blood pressure of Fijians and Indians are compared in detail with those reported in a London population. The pressures of Fijians, Indians and Londoners are similar up to the sixth decade. Thereafter, those of Fijians and Indians fall below those of Londoners.

This similarity of pressures up to the sixth decade in such contrasted races is emphasized, for ways in which the races differ have previously been held to account for differences in pressures between other races. The reasons for the differences in later years are discussed.
MORPHOGENESIS OF UNILATERAL MULTICYSTIC KIDNEY IN CHILDHOOD
Authors: BIALESTOCK DORA
Published: September 2017

The clinical details of a child R.W., aged 13 months, in whom an abnormal cystic kidney was excised, are recorded.

The microdissection study of this kidney revealed that some of the nephrons were quantitatively comparable with those of a normal kidney from a child of the same age.

Failure of union at the site of junction of distal convoluted tubules and collecting tubules of the nephrons was demonstrated in about one‐third of the nephrons studied. These observations support the embryologists who consider that the excretory and collecting systems are formed separately and unite at this junction.

All the abnormalities observed could not be explained by this simple mechanical explanation. The adverse stimuli responsible for the cystic changes in this kidney were probably active after the renal system had already normally differentiated. This would indicate that the morphogenesis of this condition, unilateral cystic disease in infancy, should be regarded as different from that of polycystic disease. Clinically, such a differentiation has been suggested by all the other reports of unilateral multicystic kidney.
SERUM LIPOPROTEINS AND BLOOD COAGULATION IN HEALTHY AND ATHEROSCLEROTIC MEN
Authors: GOLDRICK R. B.
Published: September 2017

Serial estimations of serum lipids and blood clotting were made under basal conditions in nine healthy young men and in 10 atherosclerotic older men.

When the serum concentrations of beta lipoprotein lipids were reduced by substituting unsaturated fats in the diet, there was a significant lengthening of the whole blood clotting time (W.B.C.T.) in the atherosclerotic subjects. No such change occurred in the healthy controls, and the “Stypven” time was unaltered in both groups of subjects.

The “Stypven” time was consistently longer in the healthy men, but there was no difference in the W.B.C.T. between subjects until clotting in the atherosclerotic subjects became longer with the fall in serum lipid levels.

Certain differences in the lipoprotein transport of cholesterol were noted. In the healthy subjects a rise in total cholesterol level was borne by both alpha and beta lipoproteins, although the beta fraction was mainly responsible for the rise in total cholesterol level. On the other hand, in the atherosclerotic subjects a rise in total cholesterol level was associated with a fall in alpha and a rise in beta lipoprotein. The significance of these differences in regard to atherogenesis is discussed.

Among the healthy subjects alpha lipoprotein was associated with longer clotting times in the “Stypven” test and shorter W.B.C.T. On the other hand, in the atherosclerotic men both measures of clotting varied together. As the concentration of alpha lipoprotein increased, clotting times became longer, and as the beta lipoprotein concentration rose, clotting was accelerated. These associations suggest that the serum lipoproteins or some closely associated factors influence the rate of blood coagulation.
PRECIPITIN TESTS FOR AUTO‐IMMUNIZING THYROIDITIS
Authors: WATSON D.
Published: September 2017

The results of precipitin and flocculation tests on the serum of 76 patients with thyroid disease are presented and discussed. A positive precipitin reaction to thyroid extract indicates that, at one time or other, the patient has become sensitized to thyroglobulin.

A thyroid precipitin test employing normal electrophoretic equipment is described. The test is slightly more sensitive, simpler and more rapid than the agar diffusion test. Taken in conjunction with clinical assessment and other available investigations, this precipitin test is a valuable diagnostic procedure.
HEREDITY IN PRIMARY GOUT
Authors: EMMERSON B. T.
Published: September 2017

Two family pedigrees are presented which contain persons homozygous for the gouty trait. In the first family, asymptomatic hyperuricMmia occurred in both parents of a patient with gout of extreme severity and rapid progression. The only relative with clinical gout was a cousin of the patient's mother. In the second family, gout or hyperuricæmia could be traced through five generations. From the union of one of the gouty males of this family and a hyperuricæmic female four hyperuriæmic and gouty children resulted. Three of these children are also hypertensive, and two have evidence of renal impairment. The patient in the index case in the first family had renal disease due to gout itself, while the second family demonstrates that renal disease in gouty subjects may also be due to the association in one family of hyperuricMmia and primary hypertensive vascular disease. Homozygosity for the gouty trait is suggested as a possible cause of gout occurring with undue severity or with an unusually wide family incidence.
CHANGES IN URINARY STEROID EXCRETION DURING EXAMINATIONS
Authors: MELICK ROGER
Published: September 2017

Urinary total 17‐hydroxycorticosteroid (17‐OHCS) excretion and 17‐ketosteroid (17‐KS) excretion by 10 university students during day and night periods were measured four weeks before and during university annual examinations. A significant increase in the excretion of total 17‐OHCS occurred during examinations in both day and night periods. No rise occurred in 17‐KS excretion. The normal diurnal variation of excretion was present both before and during examinations for both total 17‐OHCS and 17‐KS. It is concluded that examinations caused an increase in basal total 17‐OHCS excretion as well as an increase during the examinations themselves, and that the adrenal‐stimulating factor was not enough to cause a rise in 17‐KS excretion detectable by the method used.
ACUTE DIFFUSE INTERSTITIAL PULMONARY FIBROSIS IN SCLERODERMA
Authors: READ JOHN , COLEBATCH H. J. H. , SMITH K. VINER
Published: September 2017

A case of generalized scleroderma with pulmonary manifestations is described.

Completely normal findings on detailed studies of respiratory function three and a half months before the patient's death allow the pulmonary lesions to be described as acute diffuse interstitial pulmonary fibrosis.

The histological appearances in the lungs are believed to represent the earliest manifestations of "scleroderma lung" yet described.
BONE CHANGES ASSOCIATED WITH CORTISONE ADMINISTRATION IN THE RAT : CONVERSION OF ‘RICKETS’ TO ‘OSTEOPOROSIS’
Authors: STOREY E.
Published: September 2017

Many studies of bone disorders showing density variation have been of a general metabolic type—intake, output and serum levels of calcium and other ions. These play an important part in the development of our knowledge, but, necessarily, give only an indication of average osseous change ; this is different in different bones. Morphological studies of several individual bones in any given case are thus an essential counterpart of the other form of inquiry.

Furthermore, it seems from the recent literature that osteoporosis and osteomalacia are coming be regarded clinically, more and more, as disease conditions or possibly syndromes, whereas they should not represent more than processes. To elucidate some aspects of these questions, experimental investgations have been undertaken.

Cortisone administration to rats with fully developed low‐calcium/high‐phosphorus "rickets", characterized by widened osteoid seams and areas of bone resorption, results in disappearance of osteoid seams, diminution in size and number of bone trabeculæ and development of osteoporosis. Detailed studies of this change in bone structure show that in this form of rickets resorption is confined to calcified bone ; osteoid, lined by mast cells, does not resorb except where areas of sporadic calcification appear in it. With cortisone, osteoid material continues to calcify ; but new osteoid formation no longer appears, mast cells slowly disappear, and the area of calcified bone surface undergoing resorption increases in extent. Thus the anti‐anabolic effect of cortisone, by inhibiting further matrix formation, is indirectly responsible for increased resorption. These results suggest that "rickets" and osteoporosis are interconvertible, and that the type of bone change, in the presence of abnormal calcium metabolism of any kind, may depend on the level of cortisone (or comparable hormones).
MAXIMAL EXPIRATORY FLOW RATES IN AUSTRALIAN ADULTS
Authors: SELBY T. , READ JOHN
Published: September 2017

The Wright peak flow meter is a useful, simple, portable instrument for the recording of maximal expiratory flow rates (M.E.F.), which reflect the degree of obstruction to air flow.

Normal values for M.E.F. under Australian conditions have been determined in 44 males and 76 females, aged 18 to 78 years, who had no history of chronic respiratory disease and who had never smoked. Regression equations have been prepared for the prediction of “normal values” in practice. In normal subjects, the recorded M.E.F. may vary from the predicted value by up to 20%. In 10% of the subjects, the reproducibility of the test was not good.

Increasing age is associated with loss of M.E.F. in both sexes (for males 2·1 litres per minute, and for females 1·2 litres per minute, each year). In males, stature (as reflected by height) is important as a determinant of the absolute value for M.E.F.

In women over the age of 60 years, three determinations are adequate to achieve a maximum value, but in younger women at least four determinations and in men at least five determinations should be made.
DISSEMINATED TUBERCULOSIS AND BONE MARROW DYSCRASIAS
Authors: DAWBORN J. K. , COWLING D. C.
Published: September 2017

The clinical features and autopsy findings are described in two cases of pancytopenia, four cases of leukæmia and one case of myelofibrosis, all of which were associated with disseminated tuberculosis.

It is considered that tuberculosis preceded and may have caused pancytopenia in three cases. Diagnosis in such cases is aided by biopsy of lymph glands, liver and bone marrow from the iliac crest, and by culture of biopsy material. The pancytopenia should respond to anti‐tuberculous chemotherapy, but in one case it progressed to leukæmia despite treatment.

Tuberculosis appeared as a complication in three cases of leukæmia and in one case of myelofibrosis. These cases pursue their natural course despite anti‐tuberculous chemotherapy. Tuberculosis seems more likely to occur in patients receiving cortisone.

We consider that “ leukæmoid reaction ” to tuberculosis is not common, and that, more commonly, leukæmia is complicated by tuberculosis. In a few cases tuberculosis may be an ætiological factor in the blood dyscrasia, most commonly in cases of pancytopenia.
EARLY ENDOSCOPY AND RADIOLOGY IN THE MANAGEMENT OF HÆMATEMESIS AND MELÆNA
Authors: COOKE A. R. , SKYRING A. P. , STEPHEN D. D.
Published: September 2017

A series of 52 unselected patients with upper gastro‐intestinal tract bleeding was studied by means of a combination of endoscopy in the ward and radiology within 36 hours of admission to hospital. The early diagnosis was confirmed at autopsy, at operation or at a routine barium‐meal X‐ray examination before the patient's discharge from hospital. A positive diagnosis was made in over 80% of cases, and in no instance was a false diagnosis made. All gastric ulcers were detected by this method, but duodenal ulcers were missed on two occasions. Acute gastric erosions were seen in it patients. There remained a group of seven cases in which no diagnosis was made by either early or late investigation.

A vigorous approach to this problem is completely safe to the patient, and places further management, especially if surgery is contemplated, on a safer and surer clinical basis.
CEREBRAL ANEURYSMS AND CONGENITAL ABNORMALITIES
Authors: STEHBENS W. E.
Published: September 2017

The prevalence of congenital abnormalities in a series of 215 subjects with cerebral aneurysms proven at autopsy was not significantly greater than that in a control series of 849 subjects or in a series of 351 with non‐aneurysmal cerebral hæmorrhage. Apart from coarctation of the aorta and polycystic kidneys, the incidence was not higher than in the general population.

It is concluded that there is insufficient evidence to support the postulate that the association of cerebral aneurysms and developmental errors is significant. However, cerebral aneurysms frequently occur with polycystic disease of the kidneys and coarctation of the aorta, and these are the only two congenital diseases commonly associated with systemic hypertension. The coexistence of the lesions could be due to the concomitant hypertension and arterial degenerative disease rather than to hypothetical congenital factors.
THE ELDERLY HÆMOPHILIAC
Authors: KERR C. B.
Published: September 2017

There is evidence that more hemophiliacs are entering the older age groups. Among 20 patients aged over 40 years, two distinct patterns of disease were encountered, each depending on the severity of the hæmophilia. Severely and moderately severely affected patients were disabled from the effects of repeated hæmorrhage into joints and tissues of limbs. The dramatic bleeding of young hemophiliacs was seldom seen. Mildly affected patients were highly selected, owing to trauma or local abnormality revealing their relatively occult hæmorrhagic tendency. Gastro‐duodenal bleeding was the most frequent clinical manifestation. The implications of surgery in older hæmophiliacs are discussed. Although the therapeutic approach remains conservative, evidence is given that elective surgery may be safely offered to selected patients with otherwise irremediable crippling or dangerous disease. Socio‐economic and psychological adjustment of most patients appeared satisfactory, but several showed sufficient features of psychological or social disturbance to warrant emphasizing the importance of a sound developmental and vocational training programme in the early years of life.
THE ASSOCIATION OF RENAL TUBULAR ACIDOSIS WITH HYPERGLOBULINÆMIC PURPURA
Authors: COHEN ALEX , WAY B. J.
Published: September 2017

A case of purpura hyperglobulinænica is described in which the classical features of renal tubular acidosis were also present, and a second case of purpura hyperglobulinæmica is presented with features suggesting the early phase of renal tubular acidosis.

Attention is drawn to the possible combination of these conditions in one other case reported in the literature, and their possible ætiological relationship is discussed.
PROTEIN‐LOSING ENTEROPATHY
Authors: ESPINER E. A. , BEAVEN D. W.
Published: September 2017

A man, aged 54 years, presented with œdema, ascites and hypoproteinæmia of 20 years' duration. Results of investigation of cardiac, renal and hepatic function were normal. There was no history suggesting a gastro‐intestinal disorder and investigation of bowel function was largely unproductive. Studies with I131 albumin and polyvinyl pyrrolidone established that protein was being lost through the bowel. The I131 albumin disappearance studies were repeated under steroid cover, but no change in disappearance rates was observed. Laparotomy showed an œdematous and hyperæmic small bowel with dilatation of serosal lymphatics, while jejunal biopsy material disclosed widespread lymphangiectasia—the most striking lesion of this protein‐losing enteropathy.
THE NORMAL RANGE OF PLASMA URATE LEVELS
Authors: EMMERSON B. T. , SANDILANDS PAMELA
Published: September 2017

The plasma levels of urate were determined in a group of apparently healthy young subjects, 100 being males and 100 females, none of whom had a family history of gout or evidence of renal disease. The results in the males appeared to have a bimodal distribution, suggesting that they might represent two populations, one normal and the other hyperuricæmic. Although there was no sharp dividing line, the plasma urate levels for these two groups seemed to separate at a value of about 7·0 mg. per 100 ml. The results in females approximated more to a normal distribution, and only one result exceeded 5·7 mg. per 100 ml. If, on the other hand, the value which excluded the upper 5% of results was calculated from the mean and standard deviation (the requirement being disregarded that the distribution should be a normal one for this to apply), results almost identical with those already chosen would be obtained.

These findings have therefore suggested that values of 7·0 mg. per 100 ml. for males and 5·7 mg. per 100 ml. for females be taken as the upper limits for the normal plasma urate level estimated by the colorimetric method. A uricase method of estimation produced results which were about 0.2 mg. per 100 ml. lower than those produced by this colorimetric method. As the distribution of the results for males could also be interpreted as being a normal curve skewed towards the higher values, it is considered that much larger numbers than these would be needed to allow any conclusions to be drawn concerning the theories of inheritance of the plasma urate level.
DIAGNOSIS AND TREATMENT OF STROKES: ANATOMICAL AND PATHOLOGICAL ASPECTS
Authors: ANDERSON R. McD.
Published: September 2017

This report deals with the major findings in an autopsy series of 351 cases of cerebrovascular accident. In addition, anatomical studies are presented which help to clarify some of the pathological findings. In the cases of cerebral infarction, a high incidence of associated heart disease was found. In the hæmorrhage group, the importance of ruptured saccular aneurysm is emphasized.
ROCKY CREEK, AN OUTLYING FOCUS OF SCRUB TYPHUS IN NORTH QUEENSLAND
Authors: BARROW G. J. , DOMROW R. , DERRICK E. H.
Published: September 2017

Eight cases of scrub typhus have arisen at Rocky Creek, near Atherton, North Queensland, in a focus detached from the main scrub‐typhus region. In this comparatively dry zone, three large springs have created oases with rain forest and a highly humid microclimate. Six larval Leptotrombidium deliense were found in the ears of four of 48 small animals captured in the vicinity of the springs. The presence of these mites, although scanty, indicates that these oases still carry a potential scrub‐typhus risk, and illustrates the tendency of a focus to persist for many years. Rocky Creek, with an average annual temperature of about 69° F., is the coolest scrub‐typhus focus so far studied in Queensland.
THE USE OF THE I131 HIPPURAN RENOCYSTOGRAM IN THE DIAGNOSIS OF RENAL DISEASE
Authors: DODGE E. A.
Published: September 2017

Fifty normal subjects and 250 patients with renal disease were studied by the use of I131 sodium ortho‐iodohippurate and the external scintillation counting technique. The renographic appearances in a number of renal diseases are described, and their significance and interpretation are discussed. Special reference is made to the use of the dehydration renogram in the diagnosis of renal artery stenosis. Measurement of the bladder and urine radioactivity at the conclusion of the procedure was of value in the assessment of residual urine and the estimation of total renal function. As part of this test, a method for determining the occurrence of vesico‐ureteric reflux is described.

I131 hippuran renocystography proved to be an easily performed, well tolerated, reproducible, reliable and economic screening test of unilateral and bilateral renal function. It was of value in the diagnosis of renal disease when the intravenous pyelogram alone was inconclusive or contraindicated because of uræmia, iodine sensitivity and gross ascites, and in the very ill patient. Because the radiation dosage is minute, it may be used in following the progress of renal disease, especially in childhood.
THYMIC ABNORMALITY IN SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: MACKAY IAN R. , MASEL M. , BURNET F. M.
Published: September 2017

A young female patient with fulminant systemic lupus erythematosus, mainly affecting the brain and kidneys, required treatment with very high doses of prednisolone, up to 400 mg. per day. This led to moderate improvement in renal function, but without corresponding histological improvement. A fatal cerebral hæmorrhage occurred after ten weeks of treatment.

Necropsy revealed diffuse and focal epithelial hyperplasia and “atypical germinal centres” in the medulla of the thymus, resembling thymic abnormalities observed in lupus erythematosus by McGehee Harvey. These abnormalities were interpreted on the basis of Clark's concept of localized thymic units or “packets of cells” delimited by epithelium ; special importance was given to processes concerned with lymphocyte proliferation within these units and the passage of lymphocytes through the epithelial and endothelial barrier into the blood‐stream.

We suggest that cells entering, or arising in, these thymic units undergo primary immunological differentiation : any cells reactive with self‐components are suppressed by a substance which inhibits the development of immunological competence. The emergence of cell‐lines intrinsically resistant to control results in immunological reactions being initiated within the thymus, so causing proliferative activity of labile epithelial and endothelial cells. This, with the modifying effects of corticosteroid therapy, could produce the appearances seen in the present case.
ANGIOTENSIN, ELECTROLYTES AND ALDOSTERONE
Authors: DENTON D. A.
Published: September 2017

The first part of this paper is concerned with some aspects of renal and endocrine effects on blood pressure and the moderation of these processes by the state of sodium balance. The effects of renin and angiotensin on aldosterone secretion and mechanisms involved in the appetite for salt are considered. The proposition is advanced that any role of aldosterone in the hypertensive process is likely to be understood only when the normal mechanism of control of aldosterone secretion is determined. It has been established by experiments on the transplanted adrenal of the sheep that ionic changes in arterial blood (decrease of sodium and increase of potassium concentration) act directly on the adrenal to stimulate aldosterone secretion, and that this is one pathway of physiological stimulation. This finding has been confirmed by experiments on the dog. The direct ionic effect on the adrenal is, however, probably not the major pathway of stimulation of aldosterone secretion. At present, a central unresolved question in this field of physiology is whether the renin angiotensin system is the normal pathway of stimulation of aldosterone secretion in sodium deficiency, or whether it is a mechanism which operates only in pathological states with renal damage such as malignant hypertension. Evidence such as the correlation between the histology of the juxtaglomerular region of the kidney and sodium balance is suggestive that renin has a physiological role. Consideration of the evidence derived from acute experiments on the effect of nephrectomy on aldosterone secretion indicates the necessity of further investigation on conscious animals under conditions which are as near normal as feasible
URINARY CASTS IN EXERCISE
Authors: PATEL R.
Published: September 2017

Exercises of 30 minutes' duration and of sufficient severity to produce exhaustion resulted in the formation of large numbers of casts in the urine of eight healthy male volunteers. The coexistence of high concentration of TH mucoprotein with large numbers of casts in the urine passed after exercise suggests that casts are formed from the mucoprotein when it becomes sufficiently concentrated in the renal tubules. It has been shown in in‐vitro experiments with glass capillary tubes that deposition of TH mucoprotein is closely related to concentration (Patel et alii., 1963). It is suggested that similar factors may be concerned in cast formation in acute renal failure.
TRASYLOL: A NEW TREATMENT FOR PANCREATITIS1
Authors: MCCUTCHEON A. D.
Published: September 2017

Pancreatic proteolytic enzymes are involved in the pathogenesis of acute pancreatitis and may also be responsible for the clinical features of shock and hypotension. A proteolytic enzyme inhibitor, trasylol, is now available for the treatment of pancreatitis. Results of animal experiments are given in which trasylol was found to be effective in preventing the development of hæmorrhagic pancreatitis in dogs. Early clinical experience with trasylol in a few patients with pancreatitis is also presented. The advent of an effective, safe, proteolytic enzyme inhibitor reemphasizes the need for early diagnosis in pancreatitis.
GROSS CONGENITAL MALFORMATIONS IN SIBLINGS OF CHILDREN WITH GLUCOSE‐6‐PHOSPHATE DEHYDROGENASE‐DEFICIENT ERYTHROCYTES
Authors: HARLEY J. D.
Published: September 2017

Gross skeletal and other malformations occurred in three older male siblings of two unrelated males with glucose‐6‐phosphate dehydrogenase‐deficient erythrocytes. A history of maternal ingestion of promazine hydrochloride was obtained in one relevant pregnancy, of phenolphthalein in another, and of phenacetin, acetylsalicylic acid and extract of the pods of senna in the third. The possible significance of these observations is discussed.
THE BEHAVIOUR AND SURVIVAL OF PLATELETS IN POLYCYTHÆMIA AND THROMBOCYTHÆMIA
Authors: LANDER HARRY , DAVEY M. G.
Published: September 2017

With the use of radiochromium as a label, reduced platelet survivals were demonstrated in eight of 12 patients with polycythæmia vera. A reduced platelet survival was most commonly encountered in untreated patients with active disease, when the platelet count was abnormal, and when there was an antecedent history of either hæmorrhage or thrombosis.

Evidence is presented which suggests that the reduction of platelet survival in this condition is the result of an intrinsic abnormality in the platelets, rather than of the consumption of platelets in a continuous process of subliminal coagulation.

Normal platelet survivals were found in three patients with congenital polycythæmia, in one patient with polycythæmia associated with chronic anoxic lung disease, and in four subjects with thrombocytosis.

One patient with “hæmorrbagic” thrombocythæmia, and another with chronic myeloid leukæmia, also had reduced platelet survivals. Cross‐transfusion and surface counting studies in the latter case suggested that the platelets were being destroyed in the patient's spleen. This, in the presence of thrombocythæmia raises the possibility of a “compensatory” type of hypersplenism.
THE EFFECT OF ASPIRIN AND PHENACETIN ON ASCENDING INFECTION IN THE RAT KIDNEY
Authors: DAWBORN J. K. , KINCAID-SMITH PRISCILLA , MCLAREN JANET
Published: September 2017

Four groups of rats were fed on diets containing different amounts of aspirin and phenacetin. After 15 weeks on these diets, half the rats in each group were given an intravesical injection of Escherichia coli, and this was repeated three weeks later. All the rats were killed at the end of five months and the kidneys were examined. No difference was noted between the kidneys of control rats and those fed on drugs, although all groups showed some areas of inflammatory cell infiltration and atrophy of renal tubules similar to those said to be caused by phenacetin. The severity and incidence of infection in those rats subjected to bacterial infection was less in phenacetin‐fed rats than in controls.

The existence of a specific renal lesion due to phenacetin remains uncertain. The correct experimental conditions have not yet been found which produce renal lesions in animals similar to those attributed to phenacetin in man. Careful clinical studies rather than laboratory experiments appear to be most likely to throw further light on the role of phenacetin in renal disease in man.
HISTIOCYTIC MEDULLARY RETICULOSIS : A CASE REPORT
Authors: HIRSH J. , UNGAR B. , KING W. E. , LUBBE T. R.
Published: September 2017

The clinical, hæmatological and pathological features of a case of histiocytic medullary reticulosis are described. The course of the illness was punctuated by a number of exacerbations characterized by a sudden onset of fever. The hæmatological features were unusual, in that anæmia, which is usually a severe and very prominent feature of the disease, was only mild and intermittent. The diagnosis was not suspected clinically and was finally made by histological examination of splenic tissue obtained at splenectomy. The course of the disease was unaffected by splenectomy and by treatment with cyclophosphamide.

Brief reference is made to the relevant literature, and the features of interest are discussed.
Enhancing transnational labour solidarity: the unfulfilled promise of the Internet and social media
Authors: Geelan Torsten , Hodder Andy
Published: September 2017

This article examines the activities of Union Solidarity International (USI), a new UK‐based organisation in the international union arena. USI seeks to encourage and support international solidarity between trade unions and other worker movements around the world by harnessing the dynamism of the Internet and social media. Drawing on a combination of in‐depth semi‐structured interviews, documentary analysis, Google Analytics and social media data, the findings of this case study suggest that USI is successfully developing an international audience in the United States, the UK and Ireland. However, USI's ability to reach beyond English‐speaking countries and mobilise people to engage in collective action appears limited. The article makes an important contribution to the growing literature on social media in industrial relations through analysing the extent to which digital technologies can contribute to effective transnational labour solidarity.
Intra‐ and Inter‐Institutional Leadership of the European Commission President: An Assessment of Juncker's Organizational Reforms
Authors: Bürgin Alexander
Published: September 2017

By most accounts, the Commission President's potential for political leadership within the EU system has declined since the 1990s, due to the increasingly assertive role of the European Council, and a more autonomous European Parliament (EP). Furthermore, the incumbent's authority over the Commission is complicated by the Commission's internal fragmentation and specialization. Based on interviews with experienced policy‐makers from the Commission, the Council and the EP, this article argues that Juncker's leadership inside the Commission, as well as his leadership within the EU system have been strengthened by his organizational reforms, such as the introduction of project‐team leading Vice‐Presidents and a stronger role of the Secretariat General. These findings challenge the accounts emphasizing the declining leadership capacity of the Commission.
A new sexually dichromatic miniature Hyphessobrycon (Teleostei: Characiformes: Characidae) from the Rio Formiga, upper Rio Juruena basin, Mato Grosso, Brazil, with a review of sexual dichromatism in Characiformes
Authors: Pastana M. N. L. , Dagosta F. C. P. , Esguícero A. L. H.
Published: September 2017

Hyphessobrycon myrmex sp. nov., is described from the Rio Formiga, upper Rio Juruena, upper Rio Tapajós basin, Mato Grosso, Brazil. The new species can be distinguished from congeners by having the lower half of the body deeply pigmented with dark chromatophores, chromatophores concentrated above the anal fin and forming a broad, diffuse, dark midlateral stripe and by having a dense concentration of dark chromatophores along unbranched dorsal‐fin rays and distal portions of the two or three subsequent branched rays. In life, H. myrmex exhibits a conspicuous sexual dichromatism, with adult males red to orange and females and immatures pale yellow. A list containing 108 sexually dichromatic taxa in six families of Characiformes is provided and the distribution of this poorly known type of dimorphism across the Characiformes is discussed.
Energy drink consumption among New Zealand adolescents: Associations with mental health, health risk behaviours and body size
Authors: Utter Jennifer , Denny Simon , Teevale Tasileta , Sheridan Janie
Published: September 2017

Aim

With the increase in popularity of energy drinks come multiple concerns about the associated health indicators of young people. The current study aims to describe the frequency of consumption of energy drinks in a nationally representative sample of adolescents and to explore the relationship between energy drink consumption and health risk behaviours, body size and mental health.

Methods

Data were collected as part of Youth’12, a nationally representative survey of high school students in New Zealand (2012). In total, 8500 students answered a comprehensive questionnaire about their health and well‐being, including multiple measures of mental well‐being, and were weighed and measured for height.

Results

More than one‐third (35%) of young people consumed energy drinks in the past week, and 12% consumed energy drinks four or more times in the past week. Energy drink consumption was significantly associated with greater depressive symptoms, greater emotional difficulties and lower general subjective well‐being. Frequent energy drink consumption was also associated with binge drinking, smoking, engagement in unsafe sex, violent behaviours, risky motor vehicle use and disordered eating behaviours. There was no association between consumption of energy drinks and student body size.

Conclusions

Consumption of energy drinks is associated with a range of health risk behaviours for young people. Strategies to limit consumption of energy drinks by young people are warranted.
Talking It Through: Collaborative Dialogue and Second Language Learning
Authors: Ammar Ahlem , Hassan Rania Mohamed
Published: September 2017

This quasi‐experimental study examined the potential benefits of zero‐error dictation, a teaching technique based on dialogue‐driven dictation, and the extent to which target linguistic features and proficiency levels mediated its effects on second language (L2) learners’ accurate use of French grammatical morphology. Seventy‐nine learners of L2 French in four Grade 5 and 6 classes in the Montreal area were assigned to two conditions: traditional dictation (comparison) group and zero‐error dictation (experimental) group. The instructional intervention, which consisted of five sessions spread over a 5‐week period, targeted four different morphological features. Learners’ knowledge of the target features was tested immediately before the experimental intervention started and immediately after it ended. Findings indicated that the experimental treatment group outperformed the comparison group and that learners’ gain scores varied across the target structures and learner proficiency levels.
The introduction of public–private partnerships in the Netherlands as a case of institutional bricolage: The evolution of an Anglo‐Saxon transplant in a Rhineland context
Authors: Koppenjan Joop , de Jong Martin
Published: September 2017

In this contribution, the introduction of contractual public–private partnerships (PPPs) in the Netherlands, more specifically the use of Design, Build, Finance, Maintenance, and Operations (DBFMO) contracts in Dutch infrastructure management, is analysed using a specific strand within the policy transfer and institutional transplantation literature: that of ‘institutional bricolage’. This perspective states that policy transplants come to fit their new institutional context stepwise. This contribution reconstructs the adoption process by which the Anglo‐Saxon‐inspired PPP practice is incorporated into the traditional ‘Rhinelandic’ practice of infrastructure management in the Netherlands, identifying four waves of PPP initiatives. It concludes that these waves and the difficulties that emerge in them stem from an ongoing struggle between actor coalitions, one aiming to preserve the transplant in its original shape, and others making attempts at bricolage. Shifts in power relations explain the progress and outcomes of the process of institutional transplantation.
Responsibility for states' actions: Normative issues at the intersection of collective agency and state responsibility
Authors: Lawford‐Smith Holly , Collins Stephanie
Published: September 2017

Is the state a collective agent? Are citizens responsible for what their states do? If not citizens, then who, if anyone, is responsible for what the state does? Many different sub‐disciplines of philosophy are relevant for answering these questions. We need to know what “the state” is, who or what it's composed of, and what relation the parts stand in to the whole. Once we know what it is, we need to know whether that thing is an agent, in particular a moral agent capable of taking moral responsibility for its actions. We have to know what it takes for it to be capable of moral responsibility, e.g., what the functional equivalents in groups (or in that kind of group in particular) are of knowledge, intention, foreseeability, recklessness, and so on. And once we've established that it is an agent, and is responsible for what it does, we have to explain whether and in what way this implicates members, i.e., whether state responsibility distributes to the (compositional) members of states, whoever they may be (“citizens” is one possibility, but there are many). Answers to these questions come from metaphysics, social ontology, action theory, epistemology, political theory, and ethics. In what follows, we'll give an outline of some different ways of answering these questions.
False‐positive pregnancy test after transfusion of solvent/detergent‐treated plasma
Authors: Jilma‐Stohlawetz Petra , Wreford‐Bush Tim , Mills Francesca , Davidson Fiona , Kursten Friedrich W. , Jilma Bernd , Birchall Janet
Published: September 2017

BACKGROUND

The transmission of pathogens, antibodies, and proteins is a possible consequence of blood product transfusion. A female patient had an unexpected positive serum β‐human chorionic gonadotropin result, indicative of pregnancy, after she had received a transfusion with 1 unit of platelet concentrate, 4 units of red blood cells, and 4 units of pooled solvent/detergent‐treated plasma (Octaplas).

STUDY DESIGN AND METHODS

To investigate the possibility of passive transfusion of β‐human chorionic gonadotropin from the plasma transfusion, one additional unit from the same batch was thawed and analyzed. To validate the β‐human chorionic gonadotropin assay for use in solvent/detergent‐treated plasma and to investigate any interference in the assay, dilution experiments were performed using the implicated plasma batch diluted with male and non‐pregnant female sera. Also, plasma from a known pregnant woman was diluted with Octaplas (tested negative for β‐human chorionic gonadotropin) and with a male serum to validate the assay for use in solvent/detergent‐treated plasma.

RESULTS

The implicated solvent/detergent‐treated plasma had a mean β‐human chorionic gonadotropin level of 91.5 mIU/mL. Results from the dilution experiments revealed an excellent correlation (r > 0.99) between β‐human chorionic gonadotropin measurement in solvent/detergent‐treated plasma and male serum and no over or under recovery of the expected results. Further measurements of β‐human chorionic gonadotropin levels in the female recipient revealed an estimated half‐life of 6 hours.

CONCLUSION

This case demonstrates the importance of considering the possibility of passive transmission of analytes to a patient from the transfusion of blood products. Furthermore, the measurement of β‐human chorionic gonadotropin is valid in solvent/detergent‐treated plasma using a Roche Cobas analyzer.
Characterization of Nonplanar Second Harmonic Lamb Waves With a Refined Nonlinear Parameter
Authors: Shan Shengbo , Cheng Li , Wen Fuzhen
Published: September 2017

Structural health monitoring (SHM) methods based on the cumulative second harmonic Lamb waves show attractive advantages. An ideal nonlinear parameter should allow precise characterization of the cumulative effects of the distributed nonlinear sources such as the material nonlinearity of a plate (MNP), in the presence of other unavoidable localized nonlinear components. While highlighting the deficiencies of the traditional nonlinear parameter (TNP) in the nonplanar cases, a refined nonlinear parameter (RNP) is proposed. Through compensations for the wave attenuation associated with the wave divergence, the new parameter entails a better characterization and differentiation of the cumulative MNP and other noncumulative localized nonlinear sources. Theoretical findings are ascertained by both finite element (FE) simulations and experiments, through tactically adjusting the dominance level of different nonlinear sources in the system. Results confirm the appealing features of the proposed RNP for SHM applications.
Effects of Non-Darcy Flow and Penetrating Ratio on Performance of Horizontal Wells With Multiple Fractures in a Tight Formation
Authors: Zhang Feng , Yang Daoyong
Published: September 2017

A novel slab source function has been formulated and successfully applied to examine effects of non-Darcy flow and penetrating ratio on performance of a horizontal well with multiple fractures in a tight formation. The Barree–Conway model is incorporated in the mathematical model to analyze non-Darcy flow behavior in the hydraulic fractures, while the pressure response under non-Darcy flow is determined by two dimensionless numbers (i.e., relative minimum permeability (kmr) and non-Darcy number (FND)). A semi-analytical method is then applied to solve the newly formulated mathematical model by discretizing the fracture into small segments. The newly developed function has been validated with numerical solution obtained from a reservoir simulator. Non-Darcy effect becomes more evident at a smaller relative minimum permeability (kmr < 0.05) and a larger non-Darcy number (FND > 10). The non-Darcy number is found to be more sensitive than the relative minimum permeability, resulting in a larger pressure drop even at a larger kmr. In addition, the non-Darcy flow is found to impose a significant impact on the early-stage bilinear/linear flow regime, resulting in an additional pressure drop that is similar to lowering the fracture conductivity. The pressure response can be classified into two categories by a penetrating ratio of 0.5. When the penetrating ratio is decreased, the early bilinear/linear flow regime occurs, followed by an early radial flow regime.
Experimental Study of Mobile Solar Reverse Osmosis for Remote Areas
Authors: Almalowi Saeed J. , AlRaddadi AbdulAziz M. , AlZughabi Mostafa H. , AlHazmi Mazen M. , Masoudi Mohanned H.
Published: September 2017

Reverse osmosis (RO) technique is one of most efficient methods to desalinate the salt water. An accurate and detailed experimental method was established to analyze the performance of the unpotable water RO process, which is the solution-diffusion and mass transfer theory. The RO is going to be operated using an alternative energy source, solar energy. The solar cells are utilized to run the RO unit with a single vertical membrane. DC current is produced by a solar panel which produces 18 maximum volt and 4.25 maximum DC current. The solar panel was utilized to run out the DC booster pump without using an inverter. The production of freshwater is the major studied parameter in this project with other parameters, such as the efficiency of the RO unit and the salt rejection percentage (610 max PPM). The experimental work provides a more detailed understanding of solar RO unit in order to be utilized in the remote areas.