bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Multiphasic Biochemical Screening on the Diagnosis of Primary Hyperparathyroidism*
Authors: Aitken R. E. , Bartley Paul C. , Bryant S. J. , Lloyd H. M.
Published: March 2008

Summary: The effect of multiphasic biochemical screening on the diagnosis of primary hyperparathyroidism

Experience of primary hyperparathyroidism (PHPT) at the Royal Brisbane Hospital was reviewed to determine the effect of multiphasic biochemical screening, introduced during 1970, on the rate of diagnosis of this disease. In the period 1959–1970, there were 28 proved cases and, in the period 1971–1974, 41 cases, an increase from 2·5 to 11·7 cases per annum. The main factor contributing to this increase was the inclusion of plasma calcium in the multiphasic screening programme, together with correction of the plasma calcium for the total protein concentration in the same blood sample.
Blood Vitamin Levels in Children with Gastroenteritis
Authors: Araya M. , Silink S. J. , Nobile S. , Walker‐Smith J. A.
Published: March 2008

Summary: Clinical evaluation and estimation of blood levels of vitamins A, E, C, B1, B2, B6 and of total carotenoids were carried out in 52 consecutive children admitted to the Royal Alexandra Hospital for Children in Sydney during the winter epidemic of diarrhoea. The children included 37 Europeans and 15 Aboriginals, who were previously apparently healthy. Of these, 19 Europeans and ten Aborigines were studied also after recovery. The anthropometric, clinical, microbiological and biochemical data for each child is presented.

Vitamin treatment, duration of symptoms, severity of diarrhoea, stool microbiology and the role of secondary malabsorption as a main cause of the depressed plasma vitamin levels found is discussed.
Inappropriate ADH Secretion Associated with Massive Vincristine Overdosage
Authors: Wakem Christopher J. , Bennett John M.
Published: March 2008

Summary: A patient with acute lymphocytic leukemia is described who developed meningeal leukemia 14 months after the initial diagnosis was made. As part of his antileukemic therapy, at that time, he received prednisone and vincristine, given prophylactically to maintain a bone marrow remission. He inadvertently received 15 mg of vincristine instead of 1·5 mg. Following this overdosage he developed pancytopaenia, mild neurotoxicity and subsequently a grand mal seizure associated with the delayed onset of hyponatremia. This was presumed to be due to the inappropriate secretion of antidiuretic hormone (ADH) secondary to vincristine toxicity. This responded to fluid restriction and anti‐epileptiform therapy.
The Australian National Blood Pressure Study: A Test of the Effectiveness of Antihypertensive Therapy on the Incidence of Ischaemic Heart Disease
Authors: Abernethy J. D.
Published: March 2008

Summary:The Australian National Blood Pressure Study: A test of the effectiveness of antihypertensive therapy on the incidence of ischaemic heart disease.

Although hypertension is an acknowledged risk factor in ischaemic heart disease (IHD) the question remains whether antihypertensive therapy is necessarily beneficial. A priori, because coronary atherosclerosis is probably irreversible, the time for effective intervention would seem to be well before the development of clinical manifestations. The Australian National Blood Pressure Study, a long term clinical trial of the treatment of mild hypertension, is in principle better suited than previous trials to answer the question because the trial population selected (4000 subjects aged 30–69) contains substantial proportions ui yuunycr dye groups (26% below 45) and of females (37%) and none had manifest IHD at entry. Sensitivity to the emergence of IHD in the trial population is increased by including as diagnostic indices angina and ischaemic ECG changes, using suitably objective methods, as well as myocardial infarction and sudden death. Thus morbidity and mortality from IHD which currently accounts for 71% of trial end points (cf 19% for stroke) will effectively determine the outcome of the trial. The occurrence of a substantial proportion of subjects withdrawn from randomised treatment will mean that the question will be answered necessarily in two ways: firstly in respect of those subjects remaining on their assigned treatments and secondly in terms of all subjects initially assigned one treatment or other irrespective of the subsequent need to change treatment on ethical grounds or of the degree of compliance.
Coronary Risk Factors, II
Authors: Kannel W. B.
Published: March 2008

Summary: Prospects for prevention of atherosclerosis in the young.

There appears to be a need to protect our young from an atherogenic way of life. The average male child today has one chance in three of a cardiovascular catastrophe before age 60. Atherosclerosis and the conditions which predispose appear to have their onset in childhood. Correctable precursors of cardiovascular disease have been identified, and their contribution to risk has been estimated not only for adults but for college students as well. An analysis of the combined impact of atherogenic risk factors indicates that they exert greater force early in life than later. Although the optimal time to begin prophylaxis is not established, there is evidence to suggest that measures instituted late in life when lesions are advanced is of only limited value. Prevention of atherosclerosis is best viewed as a family affair since the propensity to disease and contributing factors tend to be shared by family members.

It is also difficult to implement effectively preventive measures which include dietary changes, weight control, exercise and restriction of cigarettes for one family member without involving the rest of the family.

Optimal levels of the correctable precursors of cardiovascular disease are not established for children. However, the rise in serum lipids, blood pressure, weight and blood sugar observed in transition from childhood to adult life is not inevitable, or desirable. Paediatricians can alter the appalling cardiovascular mortality statistics by not allowing the process or the habits and conditions which promote it to reach an irreversible stage.

Cardiovascular disease may well begin in childhood with “medical trivia” such as a tendency to obesity, moderate cholesterol and blood pressure elevations, lack of exercise and the cigarette habit. In some respects a heart attack at age 45 can be regarded as a failure of the paediatrician.

Awaiting proof of the efficacy of the indicated prophylactic measures is not acceptable since this will be a long time in coming. We must learn how to correct risk factors effectively in childhood as soon as they appear. We must establish goals based on optimal as distinct from usual levels of risk factors. Paediatricians' resolve about prevention of atherosclerosis in childhood needs to be strengthened and we must develop a sense of urgency about this.
Immunological Changes and Liver Disease Associated with α1‐Antitrypsin Deficiency
Authors: Joske R. A. , Leedman R. L. , Matz L. R.
Published: March 2008

Summary: Immunological changes and liver disease associated with alpha‐1 ‐antitrypsin deficiency.

A female aged 60 years with heterozygous alpha‐1‐antitrypsin deficiency developed a progressive and ultimately fatal liver disease with the clinical, biochemical, immunological and histological characteristics of active chronic hepatitis. It is suggested that the hepatic disease of A‐AT deficiency be included among the types of liver disease which may initiate a progressive immuno‐pathic response.
Giardiasis Following Gastric Surgery
Authors: Slonim J. M. , Ireton H. J. C. , Smallwood R. A.
Published: March 2008

Summary: Giardiasis following gastric surgery.

A patient is presented who developed acute life‐threatening diarrhoea due to infestation with Giardia lamblia. We propose that the severity of the illness may have been related to hypochlorhydria following gastric surgery.
Hypertension and Headache
Authors: Bauer G. E.
Published: March 2008

Summary: Hypertension and headache.

The frequent association between headache and hypertension has been recognized since the introduction of the sphygmomanometer. A cause and effect relationship proposed by early writers and widely accepted in the medical and lay community has been proposed, questioned and re‐examined. The purpose of this review is to scan the literature on the subject, to present some factual data obtained from a 20 year follow‐up study carried out at the Cardio‐Vascular Clinic, Sydney Hospital and to summarize some personal views currently held on the relationship of hypertension and headache.
Detection of Hepatitis B Surface Antigen in Patients with Acute Viral Hepatitis*
Authors: Lehmann Noreen I. , Gust I. D.
Published: March 2008

Summary: Detection of hepatitis B surface antigen in patients with acute viral hepatitis.
Regional Differences in Lactate Concentration in Experimental Myocardial Infarction*
Authors: Smith H. J. , Norris R. M. , Singh B. N. , Heng M. K. , Harris E. A.
Published: March 2008

Summary: Regional differences in lactate concentration in experimental myocardial infarction.
Outpatient Screening Tests for Primary Aldosteronism
Authors: Dunn P. J. , Espiner E. A.
Published: March 2008

Summary: Outpatient screening tests for primary aldosteronism. P. J. Dunn and E. A. Espiner, Aust. N.Z. J. Med., 1976, 6, pp. 131–135.

The assessment of basal plasma aldosterone and renin concentrations, and urinary aldosterone excretion has been compared with their values after a suppressive test employing mineralocorticoid induced volume expansion in five patients with primary aldosteronism and in patients with essential hypertension. Reliance upon measurements of basal plasma aldosterone concentration, plasma renin/aldosterone ratio and urine aldosterone excretion alone proved unsatisfactory for distinguishing patients with primary aldosteronism. However these patients, in contrast to those with essential hypertension, showed elevated values or no decrease in plasma aldosterone concentration following three days treatment with 400 μg fludrocortisone (florinef) daily. It is proposed that the assessment of basal plasma renin activity together with florinef suppression of plasma aldosterone are the most effective and convenient outpatient screening procedures in the diagnosis of primary aldosteronism.
Monitoring Immune Function During Immunosuppressive Therapy
Authors: Ziegler J. B. , Hansen Prudence , Cooper D. A. , Penny R.
Published: March 2008

Summary: Monitoring immune function during immunosuppressive therapy. J. B. Ziegler, Prudence Hansen, D. A. Cooper and R. Penny, Aust. N.Z. J. Med., 1976, 6, pp. 136–141.

Twenty‐nine patients with a variety of connective tissue disorders were studied for the effects of immunosuppressive therapy on non‐specific parameters of immune function. Baseline studies prior to therapy showed a frequent incidence of anergy (13%) lymphopenia (31%) and abnormal PHA response (43%). Despite these abnormalities in untreated patients it was possible to show an even higher incidence of anergy (31%), lymphopenia (66%) and abnormal PHA response (77%) following immunosuppressive treatment. The changes in lymphocyte count and PHA response were found to be statistically significant. It was found, paradoxically, that delayed hypersensitivity responses improved following institution of therapy in three patients. Clinical efficacy of immunosuppression correlated with lymphopenia and depressed PHA responses; in particular in the five patients with uncontrolled disease, these parameters were normal. Lymphocyte counts and PHA responses are the most simple and informative procedures to monitor immunosuppression in patients.
Neonatal Brain Tissue Embolism in the Lung
Authors: Tan K. L. , Hwang W. S.
Published: March 2008

Summary: Neonatal brain tissue embolism in the lung. K. L. Tan and W. S. Hwang, Aust. N.Z. J. Med., 1976, 6, pp. 146–149.

A brain tissue embolus was observed in a major pulmonary artery in the right lung, in a neonate who died from intracranial haemorrhage 36 hours after delivery. This is the fifth documented case in a neonate and the only one in whom survival had occurred beyond one hour.
Penicillin‐Induced Haemolytic Anaemia Associated with Microangiopathy
Authors: McPherson A. J. , Parkin J. D. , Hope R.
Published: March 2008

Summary: Penicillin‐induced haemolytic anaemia associated with microangiopathy. A. J. McPherson, J. D. Parkin and R. Hope, Aust N.Z. J. Med., 1976, 6, pp. 152–155.

The development of a penicillin‐induced haemolytic anaemia was studied in a patient with microangiopathy following an average daily dose of five million units of penicillin G (total dose 46 million units). It has been proposed that the combination of the benzylpenicilloyl hapten with exposed or altered erythrocyte antigens, induces an autoimmune response. In this particular case, it is suggested that erythrocyte membrane damage has predisposed to immune drug‐mediated red cell damage.
Angiotensin II Blockade in Patients with Essential Hypertension
Authors: MacGregor G. A. , Dawes P. M.
Published: March 2008

Summary: Angiotensin II blockade in patients with essential hypertension.

Patients with essential hypertension were sodium deprived by five days on a 10 mM sodium diet and were then infused with an incremental infusion of saralasin, a competitive inhibitor of angiotensin II. Patients with normal renin hypertension showed no change in lying or standing blood pressure during the infusion of saralasin. Angiotensin II is not, therefore, directly maintaining blood pressure in these patients when sodium deprived by diet, and is therefore unlikely to be playing any direct role in maintaining their blood pressure on their normal sodium intake. Patients with low renin hypertension showed a significant rise in blood pressure during saralasin infusion. Saralasin may be a further method of distinguishing low renin hypertensives from other hypertensives if they are infused when sodium deprived by diet.
Diabetes and Associated Variables in the South Australian Aboriginal
Authors: Wise P. H. , Edwards F. M. , Craig R. J. , Evans B. , Murchland J. B. , Sutherland B. , Thomas D. W.
Published: March 2008

Summary: Diabetes and associated variables in the South Australian Aboriginal. P. H. Wise, F. M. Edwards, R. J. Craig, B. Evans, J. B. Murchland, B. Sutherland and D. W. Thomas

Diabetes of a predominant maturity‐onset type has been identified as being up to ten times more prevalent in South Australian Aborigines than in Caucasians. On the evidence provided, nutritional status and obesity are thought to be dominant in the aetiology of the hyperglycaemia, although relative hyperinsulinaemia in full blood Aborigines suggests a significant racial genetic effect. It is suggested on these and other grounds that the diabetic genotype may represent a factor of previous survival advantage to the Aboriginal, now rendered deleterious by urbanization. The degree of hyperglycaemia, and its association with hyperlipidaemia, obesity, retinal arteriovenous changes and abnormal electrocardiographic findings, accentuates the significance of the diabetes, and underlines the serious need for ongoing nutritional education in these communities.
Hepatitis B Antigen Subtypes in Asymptomatic Carriers in the Solomon Islands1,*
Authors: Williams H. , Mazzur S.
Published: March 2008

Summary: Hepatitis B antigen subtypes in asymptomatic carriers in the Solomon Islands. H. Williams and S. Mazzur

Three hundred and fifty‐three students attending King George VI School in Honiara, British Solomon Islands Protectorate, were tested by immunodiffusion for hepatitis B surface antigen (HB, Ag). The prevalence of HB Ag was 13% and the antigen was found more frequently in males. Twenty‐seven samples which contained high titers of antigen were subtyped to define those subtype combinations present in the BS/P. The most frequent antigen was adr+yw‐. This combination is a/so common in Thai/and and Japan. The second most prevalent comb/nation was ayw+dr‐. The antigenic determinants also occurred less frequently as adw+yr‐, adwr+y‐, and awr+dy‐. These unusual samples which contain both w and r may be the result of mixed particles, recombination of virus, mixing of viral proteins in doubly infected cells or extracellular aggregation of mixed viral products.
The Epidemiology of Hepatitis B in a Residential Institution for the Mentally Retarded*
Authors: Boughton C. R. , Hawkes R. A. , Schroeter D. R. , Harlor Judy A.
Published: March 2008

Summary: The epidemiology of hepatitis B in a residential institution for the mentally retarded. C. R. Boughton, R. A. Hawkes, D. R. Schroeter and Judy A. Harlor, Aust. N.Z. J. Med., 1976, 6, pp. 521–529.

A longituclinal study carried out over 43 months in a residential home for the mentally retarded confirmed the marked propensity of individuals with Down's syndrome (DS) to develop chronic HB antigenaemia. This could not be accounted for by environmental factors, and a genetic basis is postulated. In addition, DS subjects appeared innately more susceptible to hepatitis B virus (HBV) infection, requiring one‐third the patient‐months of exposure of non‐Down's subjects (ND) before showing evidence of infection. The reciprocal geometric mean titre of anti‐HBS in DS subjects was 110 compared with 705 in ND subjects, suggesting a deficiency of humoral immunity in the DS subjects.

Transmission of HBV was occurring by means other than therapeutic, prophylactic, dental or diagnostic procedures, in the institution, and possible modes of transmission are discussed. These were probably both parenteral and non‐parenteral.

Eighty‐one per cent of HBV infections in the Home were subclinical.
Xylose‐1‐14 C Absorption Test: The use of Urine, Serum and Breath Analysis, and Comparison with a Colorimetric Assay
Authors: Roberts R. K. , Campbell C. B. , Bryant S. J. , Adames L.
Published: March 2008

Summary: Xylose‐1‐1*C absorption test: The use of urine, serum and breath analysis, and comparison with a colorimetric assay. R. K. Roberts, C. B. Campbell, S. J. Bryant and L. Adames, Aust. N.2. J. Med, 1976, 6, pp. 532–536.

The xylose absorption and excretion test has been reassessed in controls and patientswith coeliac disease. Xylose has been assayed in both serum and urine colorimetrically and by liquid scintillation counting using xylose‐1‐14 C The excretion of 14CO2 in breath following administration of xylose‐1‐14 C has been measured.

Liquid scintillation counting is a simple and reliable method for the measurement of xylose absorption. Serum xylose levels, urinary xylose excretion, or breath 14 COz in isolation were poor screening tests for mucosal disease. The use of serum levels and urinary excretion in combination improved the discriminatory value of the test though small gut biopsy was more reliable.
Follow‐up Studies on Liver Disease Associated with HBS Ag Carriers
Authors: Bolin T. D. , Davis A. E. , Liddelow A. G.
Published: March 2008

Summary: Follow‐up studies on liver disease associated with HBsAg carriers. T. D. Bolin, A. E. Davis and A. G. Liddelow, Aust. N.Z. J. Med., 1976, 6, pp. 539–542.

Eight male subjects who were initially studied in 1972 with liver biopsy because of HBsAg carrier status were re‐studied two years later with liver biopsy, clinical examination and standard liver function tests. Three of the eight subjects remained antigen positive and had continuing liver disease, this being either chronic active hepatitis or chronic persistent hepatitis. Two subjects became HBs Ag negative and their liver biopsies returned to normal. One subject became HBs Ag negative but his biopsy disclosed chronic active hepatitis with cirrhosis in the presence of normal liver function tests. While persistence of the antigenaemia is associated with persisting liver disease, the converse is not true in that the disappearance of the antigen does not necessarily imply an improvement in liver disease. Liver biopsy remains the only reliable means of assessing liver disease as biochemical tests of liver function and the clinical finclings may be of little value.
Duodenal Ulcer–Does it Exist in Australian Aborigines?
Authors: Bateson E. M.
Published: March 2008

Summary: Duodenal ulcer–does it exist in Australian Aborigines? E. M. Bateson, Aust. N.Z. J. Med., 1976, 6, pp. 545–547.

Analysis of barium meal examinations performed at the Darwin Hospital on 742 non‐Aboriginal patients showed that 82 (11‐5%) had duodenal ulcers.

A similar analysis of barium meal examinations performed on 94 Aboriginal patients at the same hospital did not reveal any duodenal ulcers.

Aboriginal patients form 22% of the local population and 18% of the hospital admissions.

Therefore, it is suggested that duodenal ulcer is an uncommon disease in the Aboriginal population of the Northern Territory of Australia.
Changes in Plasma Enzyme Concentrations Following Intramuscular Injections and Gastroscopy
Authors: Armstrong B. , Lloyd B. L. , Balazs N. D. H.
Published: March 2008

Summary: Changes in plasma enzyme concentrations following intramuscular injections and gastroscopy. B. Armstrong, B. L Lloyd and N. D. H. Balazs, Aust. N.Z. J. Med., 1976, 6, pp. 548–551.

The effects of intramuscular injections on plasma creatine kinase (CK), aspartate amino ‐transferase, lactate dehydrogenase, and hydroxybutyrate dehydrogenase concentrations were examined in 19 patients given intramuscular premedication for gastroscopy, and 18 patients given other intramuscular injections. Only CK concentrations showed significant increases which were as high as four times the upper limit of normal, and affected a maximum of 51% of patients at 12 hours after the first injection. Elevated CK concentrations persisted for up to 72 hours, and followed injections of diazepam, various antibiotics, and the combination of a narcotic analgesic with atropine. Gastroscopy did not appear to increase plasma enzyme concentrations in six patients who were given intravenous premedication. The significance of these finclings to the diagnosis of myocardial infarction is discussed.
Severe Haemolytic Anaemia Complicating Infectious Mononucleosis
Authors: Woodruff R. K. , McPherson A. J.
Published: March 2008

Summary: Severe haemolytic anaemia complicating infectious mononucleosis. R. K, Woodruff and A. J. McPherson, Aust. N.Z, J. Med., 1976, 6, pp. 569–570.

The case record of a patient suffering from infectious mononucleosis, complicated by severe haemolytic anaemia with overt intravascular haemolysis, is reported. Investigation of such cases usually shows a high titre of cold agglutinins with anti‐i specificity. In the case reported, the results of serological investigations were atypical, and suggested that cold agglutinins with anti‐l activity (rather than anti‐i) were predominant in the aetiology of the haemolysis.
Extensive Primary Lymphoma of the Gastrointestinal Tract
Authors: Harris A. R. C. , Herrmann R. P. , Carroll J.
Published: March 2008

Summary: Extensive primary lymphoma of the gastrointestinal tract. A. R. C. Harris, R. P. Herrmann and J. Carroll, Aust. N.Z. J. Med., 1976, 6, pp. 571–575.

A case of extensive primary lymphocytic lymphoma (lymphosarcoma) of the gastrointestinal tract is reported. At the time of presentation the patient had diffuse involvement of the gastrointestinal tract from the stomach to the ano‐rectal junction. Malabsorption was present. Pre‐treatment immunologic studies showed elevated serum IgA and IgG, but impaired humoral and cellular immunity. Death occurred 13 months after diagnosis.
Double Pylorus: A Complication of Chronic Gastric Ulcer?
Authors: John D. J. B. St. , Carter G. J. , Smith B. W. , Essex W. B.
Published: March 2008

Summary: Double pylorus: A complication of chronic gastric ulcer? D. J. B. St. John, G. J. Carter, B. W. Smith and W. B. Essex, Aust. N.Z. J Med,. 1976, 6, pp. 576–579.

A case of double pylorus with a chronic ulcer in one of the two channels is described. The patient, a middle‐aged man with active rheumatoid arthritis, required partial gastrec ‐tomy to allow continued treatment of the arthritis with anti‐inflammatory drugs. Detailed histological examination of the surgical specimen revealed features consistent with intramural penetration of an ulcer across the pyloric ring, resulting in a gastro‐duodenal fistula. The finclings provide further support for the hypothesis that the double pylorus is an acquired lesion, which occurs as an uncommon complication of chronic peptic ulcer.
An Auckland High School Health Survey
Authors: Lines D. R.
Published: March 2008

Summary: To assess the importance of racial and socioeconomic factors on the health of teenagers attending an Auckland High School a full clinical examination was conducted. The socio‐economic status of the four major racial groups, European. Maori, Pacific Island Polynesian and Asian was relatively constant and predominantly from Social Classes 4 and 5. The pattern of health in each group was not significantly different between races with the exception of a high incidence of scabies and impetigo among the Maori and Pacific Island Polynesians. These skin infections were possibly related to a significant degree of overcrowding that was found in this group where 21 to 29% of the families had five or more children under 15 years of age in the one house. Dental caries was commoner among Maori teenagers. These findings are in accord with the hypothesis that health differences between races are a reflection of socio‐economic factors rather than due to any intrinsic differences in susceptibility to disease.
Perinatal Plasma Lipid Concentrations
Authors: Potter Julia M.
Published: March 2008

Summary: The effect of the maternal environment on umbilical cord plasma lipid concentrations was studied in a group of mothers and babies. Changes in neonatal plasma concentrations during the first week of life were followed in a small group of infants. The lipoprotein distribution of the cholesterol and triglyceride content of umbilical cord plasma was similar to that seen in maternal plasma at delivery. Neonatal plasma cholesterol was significantly correlated with the cholesterol content of maternal low density lipoprotein. Neonatal plasma triglyceride concentration was related to maternal parity, duration of labour and the existence of maternal hypertension and to the occurrence of foetal distress and dysmaturity.
A Comparison of Metoprolol and Propranolol on Blood Pressure and Respiratory Function in Patients with Hypertension
Authors: Horvath J. S. , Woolcock A. J. , Tiller D. J. , Donnelly P. , Armstrong J. , Catersont Robyn
Published: March 2008

Summary: The effects on blood pressure and airway function of the chronic oral administration of two beta blocking agents, propranolol and metoprolol, were studied. Mean arterial pressure (MAP) fall was maximum with 160 mg of propranolol daily (‐12 mmHg, P < 0 05) and 100 mg of metoprolol (‐9 mmHg, P < 0 05) and MAP did not fall further with an increase in dose of either drug.

Nine of ten patients whose lung function was assessed showed a change in airway function, with a mean fall in maximal mid‐expiratory flow rate (MMFR) of 05 litres per second (I.sec‐1) on propranolol and 0–36 I.sec‐1on metoprolol. The fall was not related to smoking or to atopic status. These data support the hypothesis that there is resting beta adrenergic bronchodilator activity in non‐asthmatic subjects. This activity can be blocked by chronic oral administration of beta blocking drugs. The fall in MMFR in subjects with prior but unrecognized obstruction in the small airways may be sufficient to cause severe malfunction and these drugs should be used with caution in patients with chronic airways obstruction. The fall in MMFR was reversed by salbutamol while the patients were taking metoprolol, but not while they were taking propranolol, suggesting that propranolol has greater affinity than metoprolol for the bronchial beta adrenergic receptors.
Respiratory Function and the Chest Radiograph: An Epidemiological Study of the Significance of Minor Radiographic Abnormalities
Authors: Musk A. W. , Gandevia B. , Williams B.
Published: March 2008

Summary: Respiratory function and the chest radiograph: An epidemiological study of the significance of minor radiographic abnormalities.

Chest radiographs from 62 actively employed industrial workers were examined by six observers for thickening of bronchial walls, attenuation of midzone vessels, overinflation, and abnormal peripheral markings. One observer's findings, presented in detail, were analysed in terms of the results of a wide range of lung function tests; the performance of the remaining observers is summarised. Although overall lung function for the group was within normal limits, the analysis revealed significant associations between the radiographic signs and functional data. Thickened bronchial walls and abnormal peripheral markings were associated with functional evidence of airway disorders, and midzonal vascular attenuation was associated with a large total lung capacity, evidence of airway obstruction and a reduced diffusing capacity: radiographic overinflation was associated with large total lung capacity and evidence of airway obstruction but no decrease in diffusing capacity. Inter‐ and intra‐observer variation among experienced readers was small considering the lack of precise criteria of radiographic abnormality and the relative normality of the population studied. Less experienced observers showed evidence of a learning effect on their second reading.

The findings in this series are consistent with the hypothesis that the chest radiograph provides an index of anatomical abnormality which is reflected in changes in respiratory function. This suggests a hitherto unexplored role for the chest radiograph in epidemiological studies.
Pretibial Myxoedema: A Clinical and Pathological Study
Authors: Yeo P. P. B. , Cheah J. S. , Sinniah R.
Published: March 2008

Summary: Long acting thyroid stimulator (LATS) has been implicated in the pathogenesis of pretibial myxoedema (PTM). The objective of the present study was to seek evidence for a pathogenic role for LATS in PTM by immunofluorescent antibody study of skin biopsies from these lesions.

Six patients (five males and one female) with PTM were studied; one had associated thyroid acropachy. Four were thyrotoxic on presentation, one was euthyroid and the sixth hypothyroid.

Immunofluorescent antibody studies showed no difference in the deposition of immunoglobulin G (IgG) in the skins from PTM compared to normal skins adjacent to the lesions, skins of thyrotoxic controls without PTM, and skins of “normal control” subjects.

The results gave no support to the hypothesis that PTM results from a local antigen‐antibody tissue reaction.
Pure Red Cell Aplasia: A Report of Three Cases with Studies on Circulating Toxic Factors Against Erythroid Precursors
Authors: Lee C. H. , Firkin F. C. , Grace C. S. , Rozenberg M. C.
Published: March 2008

Summary: Three cases of pure red cell aplasia (PRCA) are reported. PRCA developed with no apparent cause in the first case, was associated with histiocytic lymphoma in the second and with diphenylhydantoin therapy in the third. In vitro studies showed the presence of toxic factors against erythroid precursors in the second and third cases. It is argued that the absence of such factors in the serum of the first case does not rule out antibody‐mediated damage to erythroid precursors in vivo as the demonstration in vitro would require antibody excess in vivo. Steroids induced a remission in the first two cases providing further evidence that an immunological mechanism is responsible for the PRCA. Withdrawal from diphenylhydantoin plus steroid therapy induced a rapid remission in the third case.
Electrocardiographic Changes Associated with Hypothermia Due to Acute Barbiturate Intoxication
Authors: Edwards R. C. , Epps R. G.
Published: March 2008

Summary: A patient with hypothermia due to acute barbiturate intoxication is presented. Features not usually present in the electrocardiograms of hypothermic patients suggested myocardial infarction. Hypothermia in temperate climates is uncommon but this diagnosis should be suspected when the characteristic electrocardiogram changes are seen.
Aspects of Membrane Structure: Updated for the Clinician
Authors: Smith J. A.
Published: March 2008

Summary: A detailed understanding of biological membrane structure is necessary to explain the basis of many diseases whose etiology result from aberrant membrane function. Dramatic advances in our understanding of the cell membrane, its composition, and the properties of its proteins and lipids (e.g. fluidity), and the interactions between these components are described below. For example, new knowledge of the membrane structural abnormalities can now explain features of lymphomas, leukaemia and hereditary spherocytosis.
Acupuncture Analgesia II. Review of Current Theories*
Authors: Mendelson G.
Published: March 2008

Summary: The ancient Chinese theory of acupuncture is described, and modern psychological, physiological, and pharmacological theories of acupuncture analgesia are reviewed. It is concluded that several of these theories have an independent validity but these are of heuristic value only; much more research is needed to establish the biological effects of acupuncture in general, and its analgesic effects in particular.
Radionuclide Quantitation of Left‐to‐Right Cardiac Shunts in Children
Authors: Mcllveen B. M. , Hoschl R. , Murray I. P. C. , McCredie R. M. , Chidiac P. , Marriott D. , Beveridge J.
Published: March 2008

Summary: Radionuclide quantitation of left‐to‐right cardiac shunts in children. B. M. Mcllveen, R. Höschl, I. P. C. Murray, R. M. McCredie, P. Chidiac, D. Marriott and J. Beveridge, Aust N.Z. J. Med., 1978, 8, pp. 500–508.

In order to evaluate the clinical usefulness of radionuclide methods measuring the magnitude of left‐to‐right cardiac shunts, a comparison has been made of the results obtained using these procedures with those estimated by cardiac catheterization. Seventy children in whom the presence or absence of a shunt had been established, were studied. Two methods for radionuclide shunt quantitation, the pulmonary to systemic blood flow ratio (Qp/Qs) of Maltz and Treves and their modified C2/C1, were evaluated. The former was found to be superior and showed a high correlation of shunt size with the catheter results. With attention to the performance of the investigation and in the data analysis, good discrimination can be achieved between normal patients and those with shunts. Because of the atraumatic nature of the investigation, it is concluded that the procedure is of value in the diagnosis of a cardiac murmur, the assessment of postoperative patients and the follow‐up of patients known to have a small shunt.
Plasma Gonadotrophins and LHRH Infusions in Anorexia Nervosa
Authors: Beumont P. J. V. , Abraham Suzanne F. , Argall W. J. , Turtle J. R.
Published: March 2008

Summary: Plasma gonadotrophins and LHRH infusions in anorexia nervosa. P. J. V. Beumont, Suzanne F. Abraham, W. J. Argall and J. R. Turtle, Aust. N.Z. J. Med., 1978, 8, pp. 509–514.

Nine female patients with anorexia nervosa were studied, three of them at different stages of weight gain. Basal plasma LH (luteinising hormone) was depressed in emaciated patients, but basal plasma FSH (follicle stimulating hormone) was normal. LH was significantly lower in patients who had been amenorrhoeic for less than 24 months than in those whose amenorrhoea was of longer duration.

LH and FSH levels were stimulated by LHRH (luteinizing hormone releasing hormone), infused at a rate of 05 μg/min for four hours. One patient, tested at 60% of standard weight, had no LH response. In all other patients below 70% of standard, the maximal LH response occurred within the first hour of infusion. In patients at higher weights, the LH response was biphasic, and the maximal level was reached during the last hour of the infusion. The FSH response, similarly, approached maximal during the first hour in patients below 70% of standard, but continued to rise throughout the infusion in patients at higher weights. Body weight expressed as a percentage of standard correlated significantly with both phases of the LH response, but not with the FSH response.

Most previous authors have found an association between low body weight and depressed pituitary gonadotrophins in anorexia nervosa. The present findings further elucidate this relationship.
Colonic and Oesophageal Disturbance in a Patient with Multiple Endocrine Neoplasia, Type 2b
Authors: Cuthbert J. A. , Gallagher N. D. , Turtle J. R.
Published: March 2008

Summary: Colonic and oesophageal disturbance in a patient with multiple endocrine neoplasia, type 2b. J. A. Cuthbert, N. D. Gallagher and J. R. Turtle, Aust. N.Z. J. Med, 1978, 8, pp. 518–520.

We report the illness of a 32‐year‐old male with the syndrome of multiple endocrine neoplasia, type 2b, which comprises medullary carcinoma of the thyroid, phaeochromo‐cytoma, oral mucosal neuromas and skeletal deformity. The patient also had evidence of ganglioneuromatosis of the alimentary tract, a finding which is held to be responsible for constipation and a number of the other gastrointestinal manifestations of the MEN, 2b. Dysphagia, which has not been previously reported in the syndrome was also present. Investigations of the oesophagus which included endoscopy, radiology and a motility study support the diagnosis of achalasia as the cause of the dysphagia.
Renal Papillary Necrosis Associated with Indomethacin and Phenylbutazone Treated Rheumatoid Arthritis
Authors: Jackson B. , Lawrence J. R.
Published: March 2008

Summary:Renal papillary necrosis associated with indomethacin and phenylbutazone treated rheumatoid arthritis.

A case of renal papillary necrosis is reported in a 55‐year‐old man with rheumatoid arthritis. He consumed 1·1 kg indomethacin and 5·5 kg phenylbutazone over the seven years prior to presentation.
The Successful Treatment of Primary Amyloidosis with Intermittent Chemotherapy
Authors: Bradstock K. , Clancy R. , Uther J. , Basten A. , Richards J.
Published: March 2008

Summary: The successful treatment of primary amyloidosis with intermittent chemotherapy.

A patient with primary amyloidosis is described with extensive vital organ involvement, including infiltration of the liver. kidney and myocardium. Treatment with intermittent melphalan and prednisone resulted in improved hepatic and renal function, a reduction in liver size and arrested amyloid deposition in the myocardium. These observations suggest that chemotherapy can halt tissue amyloid deposition, and improve the prognosis of primary amyloidosis.
Metformin Associated Lactic Acidosis
Authors: Phillips P. J. , Scicchitano R. , Clarkson A. R. , Gilmore H. R.
Published: March 2008

Summary: Metformin associated lactic acidosis.

A case of lactic acidosis occurring in association with inappropriate and excessive metformin therapy and a high serum metformin concentration is described. In the other 23 cases of metformin associated lactic acidosis reported to December 1977, renal, cardiovascular and liver disease were common. Although metformin is less likely to cause lactic acidosis than phenformin, neither drug should be prescribed in the presence of renal, hepatic or cardiovascular disease.
A Variant Chromosomal Translocation Found in a Series of 24 Patients with Philadelphia Positive Chronic Granulocytic Leukaemia*
Authors: Lyall Jan M. , Brodie G. N. , Garson O. Margaret
Published: March 2008

Summary: A variant chromosomal translocation found in a series of 24 patients with Philadelphia positive chronic granulocytic leukaemia.

The bone marrow chromosomes of 24 patients with Philadelphia positive (Ph1) chronic granulocytic leukaemia (CGL) were studied using banding techniques. In 23 patients, the Ptf had been produced by the standard translocation between chromosomes 9 and 22, but in the remaining patient, the Ph1 chromosome had been formed by a translocation between chromosomes 16 and 22. Clinical and haematological details of this patient are reported.
A Status Report on the Management of Solid Tumours
Authors: Levi J. A.
Published: March 2008

Summary: A status report on the management of solid tumours.

Progressive improvements in the management of certain paediatric and haematological malignancies have provided guidelines for the current approaches to the management of the more common solid tumours of adults. These include precise histopathological grading; comprehensive evaluation of extent of disease; staging classifications accurately correlated with prognosis and progressive evaluation of available therapeutic modalities for all stages of disease in an attempt to define the best combination of local and systemic forms of therapy.

Breast cancer is reviewed in detail as an example of the more responsive tumours where screening programs; improvements in pathological and clinical staging and the introduction of systemic chemotherapy together with optimal use of other methods of treatment for the various stages of disease gives hope for a significant improvement in long term survival statistics.

Lung cancer has also been reviewed as an example of the more resistant types of cancer where screening programmes and current therapy including the use of combination chemotherapy have given minor encouragement but not had a definite influence on long term survival. Some further gains may still be achieved with currently available techniques but major improvements will probably require the development of better therapeutic tools including radiotherapy with high linear energy transfer particles; new chemotherapeutic agents and specific forms of immunotherapy. It is also quite possible that completely different forms of therapy for these resistant tumours will be necessary to reach the desired goal of long term improvement in survival.
The Aetiology of the Sudden Infant Death Syndrome: Current Ideas on Breathing and Sleep and Possible Links to Deranged Thiamine Neurochemistry
Authors: Read D. J. C.
Published: March 2008

Summary: The aetiology of the sudden infant death syndrome: Current ideas on breathing and sleep and possible links to deranged thiamine Neurochemistry.

The sudden infant death syndrome (SIDS) is now the commonest cause of death between one week and one year of age in most western countries. An asphyxia/ death, with unrecognised hypoxic episodes during sleep in the preceding weeks, has been postulated from autopsy evidence for both acute and chronic hypoxia; the evidence includes Po2 values, intra‐thoracic distribution of petechiae, pulmonary arteriolar and right ventricular hypertrophy. Long‐term monitoring of infants resuscitated from a “near miss” SIDS demonstrates sleep apnoea, sometimes associated with episodic collapse and obstruction of the upper airway.

Physiological studies in healthy babies and animals highlight factors leading to vulnerability to asphyxia in different phases of sleep. In REM‐sleep (rapid‐eye‐movement), inhibition of intercostal muscle activity leads to: inspiratory collapse of the rib‐cage, impaired reflex compensation for airway obstruction, overall lung‐deflation with reduction of O2‐stores and rapid hypoxaemia during apnoea. In REM‐sleep, breathing efforts are not augmented by hypercapnia and the defense against asphyxia depends on reflex responses to hypoxia.

Sleep apnoea sometimes occurs in infants with a rare congenital defect of brain thiamine triphosphate. This draws attention to many similarities of modern SIDS and other infantile syndromes reported historically which involve deranged thiamine neurochemistry. Sudden unexpected deaths occur in apparently thriving infants of asymptomatic thiamine deficient mothers. Other similarities include: a peak incidence at 2–4 months of age; precipitation often by minor febrile episodes; seasonal and familial risk factors, with increased risk in twins; many common findings at autopsy.

Although asymptomatic maternal thiamine deficiency is common in western communities ingesting high carbohydrate diets containing various thiamine antagonists, the effect on infant thiamine stores has received little attention.

Future research is needed to evaluate SIDS incidence after identification and elimination of low thiamine states. Defective neural control of breathing during sleep should be evaluated in relation to thiamine‐neurochemistry, particularly to the leaky blood‐brain barrier, to glutamate and GAB A, to sympathetic denervation and to defective vagal reflexes of the lungs and larynx.
Evaluation and Peer Review of the Role of Specialist and General Medical Units in a Teaching Hospital
Authors: Douglas R. M. , Blood Anne
Published: March 2008

Summary: Evaluation and peer review of the role of specialist and general medical units in a Caching hospital.

The trend toward increasing specialization in the medical wards of teaching hospitals has important implications for future health care delivery and student teaching. A study of the likely implications of a change to a specialty oriented medical admission system at the Royal Adelaide Hospital has shown that already the general physicians are seeing little renal and endocrine disease and, that work satisfaction is greater on the specialty units than on the general medical units. Patient satisfaction marginally favoured the specialty units.

A peer review audit method was introduced to try and discern whether the quality of care was significantly different on the two types of units. Most physicians cooperated in at least one or two audits which involved them in judgements about adequacy of casenotes, management decisions, follow‐up arrangements, length of stay and investigations in randomly assigned specialty pairs of patients (cared for by specialist or general units). No clear‐cut trend was discerned favouring specialist or genera list care amongst 17 randomly selected pairs, but this part of the study was never completed, perhaps partly because of lack of enthusiasm for it by busy clinicians. The importance of maintaining a model of generalism for medical students on the teaching hospital campus is discussed in the light of the decline of the role of general physicians.
Alternative Pathway of Complement Activation by Candida Albicans
Authors: Thong Y. H. , Ferrante A.
Published: March 2008

Summary: Alternative pathway of complement activation by Candida albicans. Y. H. Thong and A. Ferrante, Aust. N.Z. J. Med. 1978, 8, pp. 620–622.

Activation of the alternative pathway of complement by Candida albicans was examined using a chemotactic assay. Two serologically defined strains and eight clinical isolates of Candida albicans were used in these experiments. The results showed that all ten strains of Candida albicans were capable of alternative complement pathway activation. These findings may provide an insight into host resistance to this infection.