bluuebunny/crossref_metadata_2025 huggingface dataset:
Urinary Excretion of Cyclic AMP in Primary Hyperparathyroidism**
Authors: Bartley Paul C. , Willgoes D. , Lloyd H. M.
Published: March 2008

Summary: Urinary adenosine 3′ 5′‐cyclic monophosphate (cyclic AMP) was assessed by a competitive protein binding method in 19 patients with primary hyperparathyroidism (PHPT) and in 15 control subjects. The mean value of 6.6 ± S.E. 0.64 μM per 24 hours for the patients with PHPT was higher (P < 0.001) than the mean control value of 3.2 ±24μM per 24 hours. In all hypercalcaemic patients without renal insufficiency, urinary cyclic AMP excretion was more than 4 μM per 24 hours and decreased in the 15 patients investigated after parathyroidectomy. In a normocalcaemic hyperparathyroid patient and in three hyperparathyroid patients with renal insufficiency, urinary cyclic AMP was less than 4 μM per 24 hours.
Silent Mitral Regurgitation
Authors: Rasaretnam Rudra , Wallooppillai N. J. , Paul A. T. S.
Published: March 2008

Summary: The occurrence of significant mitral regurgitation without the characteristic auscultatory signs, particularly the holosystolic murmur and the third heart sound, is unusual. It becomes of considerable importance when it occurs in combined lesions of the mitral valve, and more so in those areas where the treatment of mitral stenosis is by closed mitral valvotomy. Two cases of silent mitral incompetence are presented. The features that should have indicated the coexistence of regurgitation with mitral stenosis were cardiomegaly with considerable dilatation of the left atrium, and lesser degrees of right ventricular hypertrophy on electrocardiography for the severity of mitral stenosis and evidence of biventricular hypertrophy.
Treatment of Chronic Muco‐cutaneous Candidiasis by Lymphocyte Transfer Factor
Authors: Jose David G.
Published: March 2008

Summary: A beneficial clinical effect from the administration of lymphocyte transfer factor is described in six patients with idiopathic early onset chronic muco‐cutaneous candidiasis. Five patients in two families showed a familial disease pattern. Dermal anergy and failure to produce migratory inhibition factor with intact general immune function were found in patients tested. Antifungal chemotherapy was effective in clearing or markedly reducing the candidiasis and remission was maintained by repeated injections of transfer factor. Therapy was monitored using Candida skin test.
The Effects of Allopurinol and Clofibrate on the Elimination of Coumarin Anticoagulants in Man
Authors: Pond S. M. , Graham G. G. , Wade D. N. , Sudlow G.
Published: March 2008

Summary: The effects of chronic treatment with allopurinol and clofibrate on the elimination from plasma of warfarin and dicoumarol were examined in man. In addition, the binding of warfarin to human serum proteins was measured with and without clofibrate and its metabolite chlorophenoxyisobutyric acid (CPIB), both present in therapeutic concentrations. Treatment with allopurinol and clofibrate did not alter the rate of elimination of warfarin from plasma. In addition, clofibrate and CPIB caused no significant displacement of warfarin from serum proteins. This evidence supports the conclusion that the clinically significant potentiation of warfarin activity by clofibrate in man is due to an interaction at the receptor site. In contrast, treatment with allopurinol resulted in significant prolongation of the plasma half‐life of dicoumarol in one of three subjects. These data are consistent with inhibition of the metabolism of dicoumarol by allopurinol in some individuals.
A Clinical and Lung Function Study of Chronic Lung Disease and Asthma in Coastal Papua New Guinea
Authors: Anderson H. R.
Published: March 2008

Summary: A prevalence survey on the island of Karkar had previously shown that chronic lung disease was common in both sexes after the age of 35 years and that, in part, this was related to the smoking of home‐grown air‐cured tobacco. To investigate the nature of this chronic lung disease, 37 non‐tuberculous subjects with reduced ventilatory capacity (forced expiratory volume in one second less than 75% predicted) underwent clinical and lung function investigations. Ninety‐two per cent had adventitiae, 62% had chronic productive cough and 54% had dyspnoea on exertion. Lung function tests showed an irreversible obstructive defect with a variable, but on average, only moderately reduced transfer factor. The chest radiograph showed evidence of hyperinflation in 38% of cases but none had narrowing or loss of pulmonary vessels suggestive of emphysema. “Inflammatory changes” occurred in 35% and were associated with a mild but significant element of restriction. The results suggest that chronic bronchitis and chronic bronchiolitis were the main underlying abnormalities and that emphysema was comparatively unimportant.

Asthma appeared to be relatively uncommon, especially in children. The clinical and lung function findings in 16 asthmatics were essentially similar to those observed in asthmatics elsewhere and the atopic status of asthmatics and controls was similar to that observed in developed societies. In common with Highland asthmatics however, the age at onset was in early adult life rather than in childhood.
Salmonella Meningitis Treatment with Intravenous Trimethoprim
Authors: Briggs A. E. , Robinson M. F.
Published: March 2008

Summary: Intravenous trimethoprim and sulphadiazine were used in the successful treatment of Salmonella meningitis in a four months old child. Pharmacological data are presented which show good penetration of the blood‐brain barrier by trimethoprim. This combination appears to be a useful alternative therapy for gram‐negative meningitis.

Trimethoprim is a bacterial dihydrofolate reductase inhibitor which is currently administered in conjunction with Sulphamethoxazole as an oral preparation. Recently a parenteral preparation of trimethoprim (Trimethoprim Lactate Burroughs‐Wellcome) has become available for restricted use. We report our experience with the USC of this drug in an infant with Salmonella meningitis.
IgA‐Associated Glomerulonephritis
Authors: Woodroffe A. J. , Thomson N. M. , Meadows R. , Lawrence J. R.
Published: March 2008

Summary: Mesangial IgA deposition was detected by routine fluorescent microscopy of 19 cases of glomerulonephritis.

Twelve patients had a variable degree of diffuse mesangial proliferative glomerulonephritis. The heterogeneous histological findings in the other seven patients show that mesangial IgA deposition alone does not have diagnostic specificity. However, when interpretation of the mesangial IgA deposition is complemented by clinical and histological information, a group of patients with the characteristic combined features can be distinguished.
The Floppy Mitral Valve Syndrome—A Review of Fourteen Patients Requiring Valve Surgery
Authors: Luxton Michael , Peter Thomas , Hunt David , Westlake George , Sloman Graeme
Published: March 2008

Summary: The correlation of clinical features with the operative findings in 14 patients with a floppy mitral valve is discussed.

The clinical course is typified by rapidly progressive disability. An abrupt deterioration was present in five of our subjects and this may be due to rupture of chordae tendinea or stretching of the valve apparatus. The redundancy of the anterior cusp in 13 of our series may explain the absence of mid systolic clicks in all except one patient. The diagnosis of prolapse can be difficult to make prior to surgery because the prolapsed cusp may be masked by the regurgitant contrast medium. Hypokinesis and prominent sacculation of the left ventricular inflow tract suggest an associated myocardial abnormality. Calcium was present in one valve and thus mitral valve calcification does not exclude the possibility of a floppy valve in patients with mitral regurgitation.
Effect of Stasis on Intestinal Enzyme Activities
Authors: Gracey Michael , Thomas Jennifer , Houghton Murray
Published: March 2008

Summary: Activities of the small intestinal mucosal enzymes lactase, sucrase, maltase, alkaline phosphatase and N‐acetyl‐β‐glucosaminidase were studied in rats with surgically‐induced upper intestinal stasis and in control animals. The first four are brush border enzymes, the latter a lysosomal enzyme. There was reduction in the activities of all enzymes in the operated animals. This change was significant and most marked in mucosa lining the blind loop and gut distal to it; areas in which there is gross bacterial overgrowth and excessive levels of intraluminal deconjugated bile salts. The significance of these findings in relation to malabsorption consequent on bacterial contamination of the upper gut is uncertain and requires further study.
Emphysema in Papua New Guinea—A Pathological Study
Authors: Cooke Robin , Toogood Ian
Published: March 2008

Summary: The authors examined 47 lungs obtained at post mortem in Papua New Guinea. These were inflated with formalin, fixed under pressure, sliced and examined for emphysema using a “point‐counting” method. There was no emphysema before the age of 30 years. The pathological types encountered were similar to those in the United Kingdom. In patients over 50 years of age there appeared to be little difference between the amount of emphysema present in Papua New Guinea and in the United Kingdom. Environmental air pollution seemed to be relatively unimportant in the pathogenesis. Repeated lower respiratory tract infections may be more important. Emphysema appeared to be more prevalent in lowland than in highland dwellers. The findings of this pathological study supported the clinical and epidemiological studies carried out concurrently, but independently by others.
Aortic Valve Replacement Following Cadaver Renal Transplantation
Authors: Tiller David J. , Cartmill Timothy B. , Wyndham Roger , May Jim , Sands John , Shiel A. G. R.
Published: March 2008

Summary: Acute bacterial endocarditis producing aortic incompetence developed in a patient undergoing haemodialysis. Subsequent cadaver renal transplantation and aortic valve replacement has proved successful.
A Case of Hageman Factor Deficiency with Myeloid Leukaemia
Authors: McGrath K. , Koutts J.
Published: March 2008

Summary: The co‐existence of blastic transformation of chronic myeloid leukaemia and an isolated deficiency of coagulation factor XII (Hageman Factor), is reported, In the absence of any evidence of factor XII deficiency in the patient's siblings and children, it is uncertain if this represents an acquired factor XII deficiency due to myeloid leukaemia, or the coincidental occurrence of myeloid leukaemia with this autosomal recessive condition.
A Case of Lymphoma with T‐Cell Characteristics*
Authors: Burchardt K. , Kelly G. E. , Slezak P. , Vincent P. C. , Gunz F. W.
Published: March 2008

Summary: This concerns a woman of 54 who died from a rapidly progressive lymphosarcoma‐cell leukaemia with the terminal complication of toxoplasmosis. The grossly atypical lymphosarcoma cells were shown to form rosettes with sheep erythrocytes but were incapable of responding to stimulation with phytohaemagglutinin. They thus had the functional characteristics of abnormal T‐cells. The proportion of immunoglobulin‐bearing lymphocytes was greatly reduced.
Properdin and Recurrent Macroscopic Haematuria
Authors: Roy L. Paul
Published: March 2008

Summary: Kidney biopsies from ten children with recurrent macroscopic haematuria, showed mesangial deposition of IgG, IgA and complement. Eight of these ten biopsies also showed deposition of properdin, a basic euglobulin intimately involved in the alternate pathway of complement activation. Serum haemolytic complement activity was normal in the eight patients tested. Incubation of the serum at 4 °C for 24 hours did not result in any change in complement activity.

These data suggest that the mesangial inflammatory process in these patients may be mediated in part by the alternate pathway of complement activation and that the mechanism is activated locally.
An Evaluation of a New ECG Monitor which Detects and Classifies Ventricular Extrasystoles
Authors: McLean K. H. , Knuckey L. M. , Friedman Alex
Published: March 2008

Summary: An evaluation of a new ECG monitor which detects and classifies ventricular extrasystoles.

A device is described which is highly efficient in detecting and classifying ventricular ectopic beats. This instrument may have a significant role in patient monitoring. The system is based on analysis of a 5 electrode orthogonal system with comparison of QRS wave forms with a stored normal wave form. The design was based on a test tape derived from 26 patients and evaluated further on long recordings of 16 other patients. Results indicate that the device is highly reliable in QRS detection and in detection of ventricular ectopic beats. The problem of artefacts due mainly to patient movement is held within reasonable limits.
The Effect of Carbenoxolone Sodium on the Plasma 11 Hydroxycorticoid Levels in Chronic Gastric Ulceration
Authors: Gollan J. L. , Heckert R. , Mackinnon A. M.
Published: March 2008

Summary: The effect of carbenoxolone sodium on the plasma 11 hydroxycorticoid levels in chronic gastric ulceration.

The mineralocorticoid effects of carbenoxolone sodium are well established and seem related to the ulcer healing of the drug. In the present study the plasma 11 hydroxycorticoid responses were assessed in 12 patients undergoing treatment with carbenoxolone for chronic gastric ulceration. After treatment with carbenoxolone for one month the plasma 11 hydroxycorticoid levels rose significantly, suppression by dexamethasone was less marked and the normal diurnal periodicity was abolished. Carbenoxolone therapy influences the results of tests designed to assess the function of the pituitary‐adrenal axis and may lead to sub‐clinical adrenocortical hyperfunction.
Hepatitis B Antigen and Auto‐antibodies in Chronic Liver Diseases in Hong Kong
Authors: Lee Anthony K. Y.
Published: March 2008

Summary: The frequency of occurrence of hepatitis B antigen (HBAg) and certain tissue auto‐antibodies [antinuclear antibody (ANA), smooth muscle antibody (SMA) and mitochondrial antibody (MIA)] were studied with the microtiter complement fixation and immunofluorescence techniques respectively in a group of patients suffering from chronic liver diseases. These were chronic hepatitis (30), cirrhosis of the liver (66) and hepatocellular carcinoma, mostly with underlying cirrhosis (100). A group of closely matched hospital in‐patients served as controls. HBAg was found in high frequency in the patients with liver disease (60% in chronic hepatitis, 36·4% in cirrhosis and 49% in hepatocellular carcinoma) whereas tissue auto‐antibodies were found in lower frequencies (16·7%, 10·6% and 13% in the three groups respectively). However, in both the frequency was significantly higher than that in the controls (9·2% for HBAg and 0·8% for auto‐antibodies). There was a negative correlation between HBAg and tissue auto‐antibodies in the group of patients with liver disease when taken as a whole (·2= 14·3, P < 0·001). These results suggest a possible aetiological role played by hepatitis virus B in hepatocellular carcinoma through chronic hepatitis and cirrhosis in Hong Kong while the mutual exclusion between HBAg and auto‐antibodies supports the hypothesis of heterogeneity in the aetiology of chronic liver diseases. The patients with auto‐antibodies may belong to the auto‐immune category but no definite conclusion can be reached until the role played by hepatitis virus A in chronic liver diseases is clarified when more reliable techniques for its identification are available.
Spirometric Standards from 387 Healthy New Zealand Children
Authors: Liang A. , Pulley B. , Salive H. T. , Harris E. A.
Published: March 2008

Summary: Vital capacity and forced expiratory volume in 1 s were measured in 387 healthy European and 16 non‐European children aged from five to 11 years. These measurements were correlated with height, sitting height, arm span, weight, lean weight and age in various combinations. Suitable linear regression equations are presented from which these lung volumes may be predicted with confidence limits down to approximately ± 400 ml and ± 200 ml respectively.
The Relative Importance of the Major Risk Factors in Atherosclerotic and Other Diseases
Authors: Whyte H. M.
Published: March 2008

Summary: The relative importance of the major risk factors in atherosclerotic and other diseases.
Alcohol Usage as a Possible Explanation for Socio‐economic and Occupational Differentials in Mortality from Hypertension and Coronary Heart Disease in England and Wales*
Authors: Mathews J. D.
Published: March 2008

Summary: Alcohol usage as a possible explanation for socio‐economic and occupational differentials in mortality from hypertension and coronary heart disease in England and Wales.

In England and Wales in 1949‐53, those socio‐economic and occupational groups with high death rates for cirrhosis also had high death rates for hypertension and stroke. Alcohol exposure appeared to be the factor common to the 15 occupational groups with the highest death rates for cirrhosis. Although deaths certified to hypertension and stroke were relatively more frequent in these “high cirrhosis” occupations, deaths from coronary heart disease (CHD) were decreased relative to deaths from all causes. These observations suggest that although alcohol use is associated with an increased risk of hypertension, there may be a lesser increase in the risk of CHD. These observations could be of causal significance; if so, a study of the effects of alcohol should help dissociate those causal mechanisms unique to hypertension from those unique to CHD.
Rationalisation of Hospital Services for Stroke Patients
Authors: Christie David
Published: March 2008

Summary: Rationalisation of hospital services for stroke patients.

Over a six month period, the Royal Melbourne Hospital admitted 25% of the stroke patients expected from the north‐west region of Melbourne. When the private sector and Mount Royal Hospital were included, a total of 57% of expected demand was met by the hospital services of the region. The natural history of stroke in hospital consisted of an early “active” phase with a high death rate and a high investigation rate. Three weeks after admission this activity had largely subsided and it is suggested that the acute general hospital was no longer providing the most appropriate care. Transfer of patients with stroke three weeks after admission to a lower cost care situation with more appropriate use of staff would enable the Royal Melbourne Hospital to meet the demand for hospitalisation from its region.
Comparison of Plasma Lipids at Birth and in Second Year of Life
Authors: Potter Julia M. , Nestel P. J.
Published: March 2008

Summary: Comparison of plasma lipids at birth and in second year of life.

The value of measuring plasma lipids at birth as a guide to hyperlipidaemia in the future has been studied in 230 infants. There was a weak overall correlation between the cholesterol concentration at birth and during the second year of life (r=+0–215, P< 005). There was no such relationship for triglyceride concentration. Not one of seven infants showing hypercholesterolemia at birth had a raised level at follow‐up. By contrast, all seven infants whose cholesterol levels exceeded two standard deviations at follow‐up had normal values at birth.

This discrepancy may reflect the influence of diet on plasma lipids. The mean plasma cholesterol and triglyceride concentrations during the second year were significantly lower in those infants being fed diets that contained increased amounts of unsaturated fat. The likelihood of hyperlipidaemia being found during the second year of life therefore depended more on the nature of the infant's food than on the presence of hyperlipidaemia at birth. The added influence of genetic components was suggested by the finding of a greater prevalence of early cardiovascular events in the families of infants showing hyperlipidaemia at one to two years of age.
Vaginal Isolation of Neisseria Meningitidis in Association with Meningococcaemia
Authors: Reiss‐Levy Elizabeth , Stephenson John
Published: March 2008

Summary: Vaginal isolation of neisseria meningitidis in association with meningococcaemia. Elizabeth Reiss‐Levy and J. Stephenson, Aust. N.Z. J‐ Med., 1976, 6, pp. 487–489.

The isolation of meningococci from the vagina is unusual. This report concerns a young woman who presented with vaginal bleeding and subsequently developed a febrile illness which responded to oral ampicillin. The main clinical features included vomiting and drowsiness followed by a rash and arthritis. Neisseria meningitidis group B was isolated from cultures of a vaginal swab and blood. A brief literature review of genital infections with meningococci is given.
Analgesic Abuse and Kidney Disease
Authors: Stewart J. H. , Gallery Eileen D. M.
Published: March 2008

Summary: Analgesic abuse and kidney disease.

The analgesic syndrome, comprising renal disease, hypertension, peptic ulcer, anaemia and recurrent headache, accounts for widespread morbidity and mortality, especially in Queensland and New South Wales. Epidemiological and clinical evidence gathered from many Western societies implicates unsupervised consumption of compound analgesic preparations, particularly those containing phenacetin, in the causation of the majority of cases.

Laboratory experiments so far have failed to produce an entirely satisfactory model of clinical analgesic nephropathy. In small animals, papillary necrosis results from prolonged feeding with large doses of aspirin and a number of other anti‐inflammatory agents more readily than when phenacetin, paracetamol or phenazone is given alone. The apparently conflicting deductive and experimental data may be reconciled if, as indicated by preliminary observations, salicylates enhance the toxicity of phenacetin derivatives.

In planning a programme of prevention for the analgesic syndrome, the central aetiological role of non‐narcotic drug dependency must be recognized. As the analgesics to which addiction commonly occurs are the compound powders and tablets, or those containing a stimulant, these preparations should be available only in circumstances where their use can be monitored. Suspected unsupervised and unwarranted consumption of analgesics should be checked by urinary testing for drug metabolites.

Because the underlying problem of analgesic dependency is behavioural and environmental in origin rather than medical, the physician must combine forces with the social engineer to devise a definitive solution for this condition.
Haemolysis in Liver Disease: Relationship to Erythrocyte Membrane Function, Serum Bilirubin Concentration and Plasma Electrolyte Disturbances
Authors: Powell L. W. , Halliday J. W. , Cooksley W. G. E.
Published: March 2008

Summary: Haemolysis in liver disease: Relationship to erythrocyte membrane function, serum bilirubin concentration and plasma electrolyte disturbances.
The Use of High Calcium Dialysate in the Treatment of Renal Osteomalacia
Authors: Evans R. A. , Somerville P. J.
Published: March 2008

Summary: The use of high calcium dialysate in the treatment of renal osteomalacia.
A Combined Test of Anterior Pituitary Reserve*
Authors: Judd S. J. , Lazarus L.
Published: March 2008

Summary: A combined test of anterior pituitary reserve.
Cardiovascular Complications due to Pheniramine Overdosage
Authors: Bobik A. , McLean A. J.
Published: March 2008

Summary: Cardiovascular complications due to pheniramine overdosage.
The Effect of Rifampicin on Liver Morphology in Tuberculous Alcoholics
Authors: Thompson J. E.
Published: March 2008

Summary: The effect of rifampicin on liver morphology. J. E. Thompson, Aust. N.Z. J. Med. 1976, 6, pp. 111–116.

Seventy‐nine consecutive patients receiving rifampicin in combination with isoniazid and another drug, were found to have an 8.3% incidence of acute clinical liver disease. Half the patients (36) were advanced alcoholics and almost all cases of hepatitis came from this group.

Fifteen of the 36 were thought to have evidence of pre‐existing liver disease and were studied by means of serial liver biopsies.

Most of those with pre‐treatment abnormalities of liver function developed abnormalities in their biopsies, not attributable to alcohol.

In one patient active chronic hepatitis is believed to have followed irregularly taken rifampicin.

Those patients with both normal pretreatment liver function and biopsies did not develop histological abnormalities. The dangers of irregularly taken self‐administered rifampicin are stressed.

It is suggested that rifampicin is contra‐indicated in alcoholics with initial abnormal liver function tests.
Alpha Fetoprotein in Liver Disease in Papua New Guinea
Authors: Woodfield D. G. , Endo Y. , Clarke C.
Published: March 2008

Summary: Alpha fetoprotein in liver disease in Papua New Guinea. D. G. Woodfield, Y. Endo and C. Clarke, Aust. N.Z. J. Med., 1976, 6, pp. 117–120.

A radioimmunoassay method was used for the detection of alpha fetoprotein (AFP) in the sera of 112 Papua New Guinean patients who had undergone liver biopsy. Sera from 69 normal subjects and 20 hospital patients were also tested. Alpha fetoprotein was found to be elevated above normal levels in many of these subjects, but particularly in those suffering from viral hepatitis, cirrhosis and primary liver cell carcinoma (PLC). The highest values were found in patients with PLC. It is concluded that because of the elevation of AFP values in all these different types of liver disease the RIA test is not of great value in Papua New Guinea, except in the follow‐up of some patients with cirrhosis who are at risk of developing PLC and in those who have undergone treatment for PLC.
Lung Function in Asymptomatic Cigarette Smokers—The Single Breath Nitrogen Test
Authors: Armstrong John G. , Woolcock Ann J.
Published: March 2008

Summary: Lung function in asymptomatic cigarette smokers—The single breath nitrogen test. John G. Armstrong and Ann J. Woolcock, Aust. N.Z. J. Med., 1976, 6, pp. 123–126.

The modified single breath nitrogen (SBN) test and simple spirometry were used to study the lung function (LF) of 101 asymptomatic, cigarette smoking and 20 nonsmoking men aged 18 to 39 years. Abnormal LF was demonstrated in 39% of smokers. An abnormal SBN test was found in 28% of the light and 56% of the heavy smokers but only 3% were spirometrically abnormal. Only one non‐smoker had an abnormal SBN test. Closing volume and slope of the alveolar plateau, which are both measured from the SBN test, correlated poorly suggesting that the abnormality caused by smoking may differ among smokers. The SBN test is a simple test which is sensitive enough to detect LF abnormalities in young smokers. The significance of the detected abnormalities in relation to the development of chronic obstructive lung disease is not presently known.
USE OF SYSTOLIC TIME INTERVALS IN STUDYING HYPERTENSION
Authors: Tarazi R.C. , Ibrahim M.M. , Dustan H.P. , Bravo E.L.
Published: March 2008

Systolic time intervals were measured in 54 hypertensive patients divided into three groups according to severity of hypertension, variability of blood pressure levels and presence or absence of a hyperkinetic heart. The three groups were: borderline hypertension (BLH), fixed essential hypertension (FEU) and hyperkinetic essential hypertension (HEH). Systolic time intervals (STI) provided information indicating an increased cardio‐adrenergic drive in BLH and HEH. This was supported by finding that propranolol abolished the increased contractility found at rest in BLH and HEH.
RELEVANCE OF VASCULAR STRUCTURAL AND SMOOTH MUSCLE SENSITIVITY CHANGES IN HYPERTENSION
Authors: Bohr David F. , Berecek Kathleen H.
Published: March 2008

This is a mini‐review of the vascular changes that occur in experimental hypertension. Augmented vascular resistance and reactivity appear to be due to an increase both in wall thickness and in vascular smooth muscle sensitivity. The increase in wall thickness is an adaptive change that is secondary to the increase in arterial pressure; the altered smooth muscle sensitivity occurs in the absence of an increase in arterial pressure and hence may initiate the increase in vascular resistance and reactivity of experimental hypertension. Studies of subcellular function indicate that changes in smooth muscle sensitivity may be caused by an increase in cell membrane permeability and an altered handling of calcium by its subcellular sequestering system.

This review was supported by U.S. Public Health Service grant HL‐03756 from the National Heart and Lung Institute. K.H. Berecek is a predoctoral fellow supported by NIH grant PHS‐4620.
Once Daily Dosage Beta‐Blockade: Antihypertensive Efficacy of Slow Release Oxprenolol as Related to Renin and Age
Authors: Bühler F. R. , Lütold B. E. , Küng M. , Koller F. J.
Published: March 2008

Summary: Once daily dosage beta‐blockade: Antihypertensive efficacy of slow release oxprenolol as related to renin and age.

A single daily dose antihypertensive therapy with a new slow‐release (SR) form of the beta‐adrenoceptor blocking agent oxprenolol was as effective as a standard tid beta‐blocker regimen in maintaining therapeutic effects over 24 hours. The good overall response rate (target ≤ 95 mmHg diastolic) of 67% was achieved in eight of the 11 high renin patients and 16 out of the 20 normal renin ones; the five low renin patients, who were also older, proved to be non‐responsive. In terms of age, 83% of the patients aged under 40 years showed a reduction in diastolic pressure to ≤ 95 mmHg, this percentage being significantly better than the 50% response rate in the 40–56‐year‐olds.

In nine of the 12 beta‐blocker non‐responders the diastolic blood pressure was reduced to ≤ 95 mmHg by adding a diuretic, and in four of the nine, all of them low renin patients, this effect persisted in response to diuretics alone. Oxprenolol SR suppresses renin acutely (59%) and chronically (62%), and it blunts the renin stimulatory effects of diuretics.
Labetalol (AH5158), a Competitive Alpha‐and Beta‐Receptor Blocking Drug, in the Management of Hypertension
Authors: Rosei E. Agabiti , Brown J. J. , Fraser R. , Lever A. F. , Morton J. J. , Robertson J. I. S. , Trust P. M.
Published: March 2008

Summary: Labetalol (AH5158), a competitive alpha‐and beta‐receptor blocking drug, in the management of hypertension. E. A. Rosei, J. J. Brown, R. Fraser, A. F. Lever, J. J. Morton, J. I. S. Robertson and P. M. Trust, Aust. N.Z. J. Med., 1976, 6, pp. 83–88.

The effects of intravenous labetalol, a drug with both alpha‐and beta‐adrenergic receptor blocking actions, have been studied in 20 severely hypertensive patients. There was a prompt and sustained fall in arterial pressure; severe hypotension did not occur in recumbent patients but postural hypotension was common. Pulse rate was consistently reduced, but bradycardia was not a problem. Significant and correlated falls in plasma angiotensin II and aldosterone were seen. In a direct comparison with intravenous propranolol, labetalol was less effective in lowering plasma angiotensin II, but more effective in reducing blood pressure.

Oral labetalol provided good control of blood pressure and other features in two patients with phaeochromocytoma.

Intravenous labetalol was similarly effective in controlling a hypertensive crisis following clonidine withdrawal.
Assessment of the Value of Factor VIII Procoagulant and Antigen Ratio in the Diagnosis of Carriers of Haemophilia*
Authors: D'Souza S. , Ekert H. , Ananthakrishnan R. , Wluntz R. H.
Published: March 2008

Summary:Assessment of the value of factor VIII Procoagulant and antigen ratio in the diagnosis of carriers of haemophilia. S. D'Souza. H. Ekert. R. Ananthakrishnan and R. H. Muntz

The detect/on rate of carriers of haemophilia was evaluated using the ratio of factor VIII Procoagulant activity (VIIIc) to factor VIII antigen (VIIIag). In normals the correlation coefficient of VIIIc to VIIIag was 0–82. In 15 obligatory carriers of haemophilia whose VIIIc and VIIIag levels were studied in the authors' laboratory there was no correlation between VIIIc and VIIIag and the ratio of VIIIc to VIIIag was below the lowest normal value in 12 (80%). In all five obligatory carriers whose VIIIc levels were estimated in the referring institution and VIIIag levels in the authors' laboratory the ratio was below the lowest normal value. In 17 sisters of hemophiliacs studied here or referred for estimation of VIIIag only, an abnormal ratio was found in seven. Of 25 mothers of hemophilic children without a family history of haemophilia 16 were found to have an abnormal ratio. This incidence of haemophilia carriers is close to that expected on theoretical grounds but the interpretation of the results is complicated by the small numbers of patients all of whose studies were performed entirely in the authors' laboratory. In two normal individuals, one of who was on a contraceptive pill, there were no fluctuations of the ratio of VIIIc to VIIIag during the menstrual cycle. In one obligatory carrier with a normal ratio there was also no fluctuation.

It is concluded here that a measurement of the ratio of VIIIc to VIIIag is a valuable adjuvant in genetic counselling in haemophilia.
Hypertension Due to Renal Tuberculosis: Assessment by Renal Vein Renin Sampling
Authors: Stockigt J. R. , Challis D. R. , Mirams J. A.
Published: March 2008

Summary: Hypertension due to renal Tuberculosis: Assessment by renal vein renin sampling. J. R. Stockigt, D. R. Challis and J. A. Mirams

A 36‐year‐old man with asymptomatic hypertension was shown to have destruction of the right kidney due to renal tuberculosis. The peripheral renin level was normal, but renal vein renin sampling showed predominant renin secret/on from the right kidney both in basal samples and after acute stimulation of renin re/ease with intravenous diazoxide. Nephrectomy has resulted in marked reduction of blood pressure without treatment one year after operation. The findings support the predictive value of renal vein renin sampling when hypertension is associated with renal parenchymal disease, even when peripheral renin is normal.
Aspects of the Use of Lithium for the Non‐Psychiatrist
Authors: Williams W. O. , Györy A. Z.
Published: March 2008

Summary: Aspects of the use of lithium for the non‐psychiatrist. W. O. Williams and A. Z. Györy

Lithium carbonate is commonly used in psychiatry, particularly in the management of the manic‐depressive syndrome. It is also being increasingly tried in a variety of physical disorders.

This essentially practical article summarizes important non‐psychiatric aspects of the use of the drug, including its less common actions. Contra‐indications to the use of lithium are discussed, and the management of lithium intoxication is outlined.

Aspects of the Use of Lithium for the Non‐Psychiatrist
Drug Interactions in the Management of Rheumatoid Arthritis*
Authors: Muirden K. D. , Barraclough D. R. E.
Published: March 2008

Summary: Only some of the areas of drug interactions of relevance to those treating rheumatic diseases have been mentioned and there are still enormous gaps in our knowledge. It is likely that some potential areas of danger have been over‐emphasised
19, being based on speculation rather than real data or purely animal experiments using non‐clinical doses of drugs. We are learning how certain drugs can stimulate or inhibit the metabolism of other drugs through effects on liver enzymes systems.2For example the metabolism of corticosteroids is induced by phenylbutazone (and also by phenobarbital and phenytoin).

The patient with active rheumatoid arthritis with a low serum albumin would be unusually susceptible to changes induced by combinations of highly protein‐bound anti‐inflammatory drugs. Finally, although drug interactions are responsible for adverse effects it has been suggested that a more frequent cause of therapeutic failure is not drug interactions but the increase in the number of drug defaulters when more than one drug is prescribed.
20
The Probable Significance of Hypertriglyceridaemia in Viral Hepatitis*
Authors: Aiyathurai J. E. J. , Sentheshanmuganathan S.
Published: March 2008

Summary: The probable significance of hypertriglyceridaemia in viral hepatitis. J. E. J. Aiyathurai and S. Sentheshanmuganathan, Aust. N.Z. J. Med., 1976, 6, pp. 529–532.

It is proposed that the raised serum glutamic pyruvic transaminase activity (SGPT) in viral hepatitis reflects an adaptive increase in glutamic pyruvic transaminase in muscle for the increased transamination of alanine for post‐absorptive glucose homeostasis.

However, in a disease where the SGPT is elevated for four to six weeks, muscle cannot be an indefinite source of alanine unless it could, concurrently, resynthesize alanine.
Abnormal “Activated” Rosette Formation in Patients with Gastrointestinal Cancer
Authors: Walters B. A. J. , Rutherford J. C. , Wall J. R.
Published: March 2008

Summary: Abnormal “activated” rosette formation in patients with gastrointestinal cancer. B. A. J. Walters, J. C. Rutherford and J. R. Wall, Aust. N.Z. J. Med., 1976, 6, pp. 536–539.

The mean percentage of peripheral blood lymphocytes forming fast spontaneous rosettes with sheep red blood cells was estimated in 40 patients presenting with gastrointestinal symptoms suggestive of cancer. Patients who were eventually diagnosed as having cancer had significantly lower numbers (P < 001 Mann Whitney Test) of rosette forming cells than patients who had gastrointestinal tumours successfully removed, or patients with other gastrointestinal diseases.

The use of this test as an aid to the diagnosis of gastrointestinal malignancy and its possible application to the detection of recurrences of cancer after surgery are discussed.
Detection of Vesicoureteric Reflux Using Radionuclide Micturating Cystography
Authors: Bailey R. R. , Stapleton Patricia , Turner J. G. , Brownlie B. E. W.
Published: March 2008

Summary: Detection of vesicoureteric reflux using radionuclide micturating cystography. R. R. Bailey, Patricia Stapleton, J. G. Turner and B. E. W. Brownlie, Aust. N.Z. J. Med., 1976, 6, pp. 542–544.

Radionuclide micturating cystography (RMC) has been compared with the standard micturating cystourethrogram for detecting vesicoureteric reflux (VUR). Of 16 renal tracts with VUR radiologically classified as gross all had reflux demonstrated on RMC and in 15 of these the reflux reached the renal pelvis. Eight of the 12 renal tracts with moderate VUR and three of four with slight VUR were shown to reflux on RMC.

RMC should prove valuable for following the course of patients with VUR treated surgically or conservatively because of the lower gonadal radiation dose resulting from this technique compared with the conventional radiological method.
Studies on Serum Amylase in Normal Man and in Acute Pancreatitis
Authors: MacGregor I. L. , Zakim D.
Published: March 2008

Summary: Studies on serum amylase in normal man and in acute pancreatitis. I. L MacGregor and D. Zakim, Aust. N.Z. J. Med. 1976, 6, pp. 551–556.

Amylase isoenzymes in serum, urine, saliva, jejunal juice, and pancreatic tissue were separated by isoelectric focusing. Isoamylase patterns obtained indicated that the majority of amylase activity in normal serum is of salivary gland origin. Pancreatic amylase is characteristically predominant in acute pancreatitis. The increased renal clearance of amylase in acute pancreatitis may be partly due to the increased proportion of the smaller molecular weight pancreatic amylase. However, a demonstrated increase in the renal clearance of salivary amylase in acute pancreatitis suggests a renal cause also. Autopsy pancreas samples devoid of TAME (p‐tosyl arginine methyl ester) esterase activity (e.g. trypsin and plasma enzymes such as thrombin and pi asm in) had isoenzyme patterns different to those samples with free proteolytic activity. Incubation of TAME esterase free pancreas with trypsin caused conversion of the former isoamylase

pattern to one with the predominant isoenzymes focusing coincident with the predominant peak in serum from acute pancreatitis, jejunal aspirate, and TAME esterase positive autopsy pancreas. Such conversion suggests that pancreatic amylase is synthesized in a form different from that found in the intestinal lumen and serum.
Drug Induced Interstitial Nephritis, Hepatitis and Exfoliative Dermatitis
Authors: McMenamin Robyn A. , Davies L. M. , Craswell P. W.
Published: March 2008

Summary: Drug induced interstitial nephritis, hepatitis and exfoliative dermatitis. Robyn A. McMenamin, L M. Davies and P. W. Craswell, Aust. N.Z. J. Med., 1976, 6, pp. 583–587.

Acute interstitial nephritis associated with hepatitis, exfoliative dermatitis, fever and eosinophilia is uncommon. The syndrome has been described previously in association with phenindione administration, leptospir‐osis and heavy metal poisoning. Four cases are described, two of which were due to phenindione sensitivity. The other two patients had been exposed to a number of toxins inclucling allopurinol, frusemide, chlorothiazide and methyldopa so that the exact aetiological agent is unclear. Interstitial nephritis should be considered as a cause of acute renal failure in patients with other features of drug hypersensitivity.
Systemic Herpes Simplex Infection with Fulminant Hepatitis Post‐Transplantation
Authors: Holdsworth S. R. , Atkins R. C. , Scott D. F. , Hayes K.
Published: March 2008

Summary: Systemic herpes simplex infection with fulminant hepatitis post‐transplantation. S. R. Holdsworth, R. C. Atkins, D. F. Scott and K. Hayes, Aust. N.Z. J. Med. 1976, 6, pp. 588–590.

Immunosuppression for renal transplantation is associated with the risk of severe overwhelming infection with ubiquitous but normally relatively harmless micro‐organisms. In recent years a number of adult cases of fatal hepatitis due to herpes simplex virus (HSV) infection have been reported. Nearly always immune deficiency was a significant factor. A case of fatal HSV infection with hepatitis following transplantation is reported. The case failed to respond to infusion with the antiviral agent cytosine arabinoside. The presentation, diagnosis and treatment of HSV fulminant hepatitis is discussed.
Exercise Induced Tachycardia after Cessation of Practolol Therapy
Authors: Hunt O. , McRae C. , Ramshaw Jayne , Cole Penney , Sloman J. G.
Published: March 2008

Summary: Two studies were performed to assess the duration of action of practolol following therapeutic dosage and sudden cessation. The first study involved 19 patients who had completed a two‐year double‐blind study of the possible benefits of practolol following an acute myocardial infarction. Eleven of these patients had received 400 mg of practolol a day and eight had received placebo tablets. Exercise tests on a stationary bicycle were carried out before, and then two‐and‐a‐half, seven and ten days following discontinuation of medication. The patients were exercised up to a work level of 150 watts and the maximum heart rate noted. The resting heart rates were similar in both the practolol and placebo treated patients (P > 005), both while on and after discontinuation of the medication. There was, however, a significant difference in the maximal heart rate achieved on exercise between the practolol and placebo treated patients, while on medication (mean maximal heart rates 106 and 139/min, P < 0001 J, attwo‐and‐a‐half days (mean rates 124 and 1471 min, P < 005), but not at seven days (mean rates 135 and 146/min, P > 005) after cessation of medication.

In the second study, 12 healthy volunteers took practolol (400 mg/day) and placebo, each for a two‐week period, in random order. Exercise tests were performed while the volunteers were receiving medication and every 12 hours for 84 hours after cessation of medication. The maximum heart rates again were significantly different to 48 hours (P < 0005), but were not significantly different at 60 hours (P > 005).

It is, therefore, concluded that when practolol is given orally for a period of two weeks or more, its duration of action after abrupt cessation is approximately 60 hours, as assessed by the heart rate response to a constant exercise load.
The Use of Clonidine by Intramuscular Injection in the Treatment of Hypertension*
Authors: Graham R. M. , Gain J. M. W. , Stokes G. S.
Published: March 2008

Summary: Clonidine (Catapres) administered intramuscularly in a dose of 150 μg produced a satisfactory reduction in blood pressure in 13 of 16 hypertensive patients. Its effect occurred within five minutes, was maximal at 75 minutes and persisted for five hours. In six patients who received two doses (150 μg and 300 ng), the response was shown to be dose‐related. No serious side effects were noted. Intramuscular administration of clonidine thus appears to be safe and effective. It has a place in the management of uncontrolled hypertension when a rapid reduction in blood pressure is undesirable and in the maintenance of blood pressure control when oral therapy cannot be tolerated.
Blood Lipids and Lipoproteins in a Rural New Zealand Population*
Authors: Nye E. R. , Sutherland W. H. F. , Larking P. W. , Spears G. F. S.
Published: March 2008

Summary: Plasma cholesterol and triglycerides have been measured in 1202 residents of Milton, a rural town in New Zealand. Cholesterol and triglyceride concentrations in the serum lipoprotein classes of a random subgroup of the population are also reported. Mean plasma triglycerides and very low density lipoprotein (VLDL) cholesterol and triglyceride concentrations were higher for men, but mean high density lipoprotein (HDL) cholesterol concentration was higher in women. Urban‐rural differences in plasma cholesterol are suggested since mean plasma cholesterol concentration in men reached a maximum in the 50–59 decade in the rural town (Milton) but the maximum for a nearby urban community was in the 40–49 decade. An evaluation of hyperlipidaemia by using arbitrary cut‐off values for plasma cholesterol and triglyceride concentrations showed a prevalence of hypertriglyceridaemia in men, resulting in approximately three times as many men as women in some of the categories of hyperlipidaemia. Further, 26% of the 35–59 age group in the population had lipid risk factors for coronary heart disease.
Jaundice in Multiple Myeloma: The Role of Oxymetholone
Authors: Young G. P. , Bhathal P. S. , Wall A. J. , Sullivan J. R. , Hurleytt T. H.
Published: March 2008

Jaundice complicated the course of disease in 11 (41%) of 27 consecutive patients with multiple myeloma. In only one patient was myeloma cell infiltration of the liver the sole cause of jaundice. One patient was found to have carcinoma of the pancreas. In nine jaundice developed during therapy with the bone marrow stimulant oxymetholone. Liver histology in six of the nine showed cholestatic hepatitis or a predominantly cholestatic reaction; clinical events were consistent with oxymetholone‐induced cholestasis in the remaining three. In addition to oxymetholone all patients were receiving intermittent therapy with melphalan, prednisolone and procarbazine, but such therapy was not temporally related to the onset of jaundice. All jaundiced patients were HBsAg negative. Of the 19 patients treated with oxymetholone for refractory anaemia, nine (47%) developed jaundice. The reason for such a high complication rate is obscure. Three of these patients, who showed a severe cholestatic hepatitis, died in acute liver failure. These results indicate that high doses of oxymetholone should be used with great care in the therapy of refractory anaemia in multiple myeloma.