bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimating the Causal Effects of Media Coverage on Policy‐Specific Knowledge
Authors: Barabas Jason , Jerit Jennifer
Published: December 2008

Policy facts are among the most relevant forms of knowledge in a democracy. Although the mass media seem like an obvious source of policy‐specific information, past research in this area has been plagued by design and methodological problems that have hindered causal inferences. Moreover, few studies include measures of media content, preventing researchers from being able to say what it is about media coverage that influences learning. We advance the literature by employing a simple but underutilized approach for estimating the causal effects of news coverage. Drawing upon a unique collection of cross‐sectional survey data, we make within‐survey/within‐subjects comparisons under conditions of high and low media coverage. We show how the volume, breadth, and prominence of news media coverage increase policy‐specific knowledge above and beyond common demographic factors.
How Should We Estimate Public Opinion in The States?
Authors: Lax Jeffrey R. , Phillips Justin H.
Published: December 2008

We compare two approaches for estimating state‐level public opinion: disaggregation by state of national surveys and a simulation approach using multilevel modeling of individual opinion and poststratification by population share. We present the first systematic assessment of the predictive accuracy of each and give practical advice about when and how each method should be used. To do so, we use an original data set of over 100 surveys on gay rights issues as well as 1988 presidential election data. Under optimal conditions, both methods work well, but multilevel modeling performs better generally. Compared to baseline opinion measures, it yields smaller errors, higher correlations, and more reliable estimates. Multilevel modeling is clearly superior when samples are smaller—indeed, one can accurately estimate state opinion using only a single large national survey. This greatly expands the scope of issues for which researchers can study subnational opinion directly or as an influence on policymaking.
Social Networks and Collective Action
Authors: Siegel David A.
Published: December 2008

Despite growing attention to the role of social context in determining political participation, the effect of the structure of social networks remains little examined. This article introduces a model of interdependent decision making within social networks, in which individuals have heterogeneous motivations to participate, and networks are defined via a qualitative typology mirroring common empirical contexts. The analysis finds that some metrics for networks' influence—size, the prevalence of weak ties, the presence of elites—have a more complex interaction with network structure and individual motivations than has been previously acknowledged. For example, in some contexts additional network ties decrease participation. This presents the potential for selection bias in empirical studies. The model offers a fuller characterization of the role of network structure and predicts expected levels of participation across network types and distributions of motivations as a function of network size, weak and strong ties, and elite influence.
Friction and Party Manifesto Change in 25 Countries, 1945–98
Authors: Walgrave Stefaan , Nuytemans Michiel
Published: December 2008

Political processes are affected by “friction.” Due to cognitive limitations and institutional delays, political agendas do not adapt smoothly to real‐world impulses; political agendas either ignore them or overreact. The first question this article tackles is whether the same punctuated change process can be observed in party manifestos. Secondly, it examines whether there are differences across political systems and across party lines. Thirdly, the study tries to account for differences in the degree of “punctuatedness” of party manifestos. Drawing on the vast dataset of the Manifesto Research Group, the article shows that party manifestos are indeed characterized by friction and resistance to change; it also establishes that there are considerable differences in frictional patterns between parties and political systems; and it finds that electoral fragmentation, government participation, and electoral volatility are key to understanding these differences.
Incorporating sustainable practices for zoos and aquariums: a Triple Bottom Line approach
Authors: TOWNSEND S.
Published: December 2008

The zoological sector has a responsibility to reduce its environmental impacts and extend its positive contribution to society, in accordance with its commitment to sustainable development. This paper focuses on how zoos and aquariums (‘zoos’) can improve their sustainability performance using a Triple Bottom Line (TBL) framework. This framework helps to identify and shape how the ecological integrity and social contributions of zoos can be upheld and enhanced alongside economic commitments. Only when these three elements are in balance will a more sustainable outcome be achieved. This paper describes zoo‐based functions that fit within the TBL framework to suggest how zoos may best improve their sustainability performance. The paper includes results from a 2007 survey conducted by the author involving 52 British & Irish Association of Zoos & Aquariums member zoos.
Clinical evaluation of Brinaldix. A new oral diuretic
Authors: Briggs J D , McSween R N M , Kennedy A C
Published: December 2008

‘Brinaldix’, a new non-thiazide oral diuretic, has been used in a trial on three normal subjects and fourteen patients with oedema from various causes. It is a potent salidiuretic and proved superior to bendrofluazide in 10 out of 14 patients. It produced a substantial potassium diuresis, and we are of the opinion that potassium supplements should be given in conjunction with it. In one normal subject it produced a period of postural hypotension; no other major side-effects were noted.
Infectious-mononucleosis-like syndrome following haemodialysis for carbon tetrachloride poisoning
Authors: Proudfoot A T , Macdonald R H
Published: December 2008

A patient with renal failure after carbon tetrachloride poisoning is presented. Haemodialysis was required and renal function recovered completely. Convalescence was complicated by the development of an infectious-mononucleosis-like syndrome. The aetiology of this condition is discussed. The present case is the first to be reported after haemodialysis and transfusion of blood stored for at least 2 days.
Biochemistry of hyperthyroidism and hypothyroidism
Authors: Hoch Frederic L
Published: December 2008

The thyroid hormones act directly on mitochondria, and thereby control the transformation of the energy derived from oxidations into a form utilizable by the cell. Through their direct actions on mitochondria, the hormones also control indirectly the rate of protein synthesis and thereby the amount of oxidative apparatus in the cell. A rationale for the effects of thyroid hormone excess or deficiency is based upon studies of the mechanism of thyroid hormone action. In hypothyroidism, slow fuel consumption leads to a low output of utilizable energy. In hyperthyroidism, rapid fuel consumption leads to a high energy output, but as efficiency decreases, the utilizable energy produced decreases. Many of the chemical and physical features of these diseases can be reduced to changes in available energy.
The aetiology and pathogenesis of hyperthyroidism
Authors: Hetzel Basil S
Published: December 2008

Studies of thyroid stimulating activity of serum from thyrotoxic patients has revealed an abnormal prolonged response in the mouse present in 40-60% of patients depending on the criteria used. This agent designated long acting thyroid stimulator (LATS) is a 7S globulin. Transplacental passage of LATS accounts for neonatal thyrotoxicosis—a self-limited disease. LATS is also more readily detected in patients with large goitre, exophthalmos, pretibial myxoedema and recurrence following therapy. Thyroid ablation is usually followed by a fall in the level of LATS. A fall may also be produced by steroid therapy or immunosuppressive agents. LATS probably arises from lymphoid tissue which accounts for the non-suppressibility of the hypersecreting thyroid. Its discovery provides strong evidence that hyperthyroidism is often, though not always, a disorder of immunological tolerance.
Thyrotoxic muscle disease
Authors: Ramsay Ian
Published: December 2008

Evidence suggests that most hyperthyroid patients have a proximal myopathy. The more severe this is the more frequently are distal muscles, and ultimately, bulbar muscles involved. Probably acute thyrotoxic myopathy or encephalopathy supervenes on a previous chronic background or occurs concurrently with skeletal muscle involvement. Using careful electromyographic techniques evidence of myopathy may be found in most thyrotoxics; it disappears with adequate treatment of the primary disease.

Myasthenia gravis and periodic paralysis are also associated with thyrotoxicosis and their differentiation is discussed. Infiltrative ophthalmopathy is not related to the effects of excess thyroid hormone, but is possibly due to EPS working in conjunction with LATS.
Major vascular complications in Behçet’s syndrome
Authors: Enoch B Anthony , Khoo T C L , Castillo-Olivares J L , Grainger R G , Henry L
Published: December 2008

Two patients with Behçet’s syndrome are described. One patient developed spontaneous bilateral popliteal artery aneurysms and the other spontaneous thrombosis of the superior vena cava. These cases emphasize that primary inflammatory lesions of large vessels, with arterial aneurysm formation and thrombosis may be a feature of the syndrome.
Constipation: definition and classification
Authors: Hinton J M , Lennard-Jones J E
Published: December 2008

When a patient complains of constipation it is important to find out exactly what is meant by the term. A detailed history, general physical examination, digital examination of the anus and rectum, sigmoidoscopy and possibly barium enema or other investigations are needed to exclude recognized clinical causes of decreased bowel frequency or difficulty in passing the stools.

Among patients without obvious disease, a frequency of fewer than three bowel actions weekly is found in less than 1% of the population. Some patients complaining of decreased bowel frequency in fact pass a normal number of stools each week.

The intestinal transit rate of patients complaining of consipation may be measured simply using radio-opaque markers. Those patients with a normal transit rate do not need chemical or osmotic laxatives, though a bulk laxative may be helpful. Patients with a slow transit rate appear to need regular laxatives. A few patients are seen who conceal their bowel actions. Some young patients have a normal transit rate round the colon but stools accumulate in a large and insensitive rectum. These patients do not require laxatives so much as training and local treatment to help the rectum to empty.
Cardiac aneurysm after myocardial infarction
Authors: Groden Bernard M , James Wilson B , McDicken Ian
Published: December 2008

Ten cases of post-infarction cardiac aneurysm have been described in detail. Many of the patients had survived for several years after the infarction which was held to be responsible for the formation of the aneurysm. It is suggested that in most cases the diagnosis can be made on the basis of a PA chest radiograph combined with careful cardiac fluoroscopy. If surgery is contemplated because of cardiac failure which does not respond to medical treatment or because of embolic phenomena not controlled by anticoagulant therapy, left heart angiography and coronary arteriography are indicated.
Medullary cystic disease of the kidney: its occurrence in two siblings
Authors: Handa Satya Paul , Tennant Robert
Published: December 2008

Two cases of medullary cystic disease of the kidney in two siblings are presented. In both siblings there was an insidious onset of azotaemia and anaemia at an early age. The urinalyses were normal except for a trace of proteinuria and persistent low specific gravity. The kidneys were small by radiological studies and this was proved at necropsy. The gross microscopic appearances of the kidneys were consistent with medullary cystic disease. The literature on this subject and current views on the similarities between familial juvenile nephronophthisis and this condition are discussed.
Heart size in thyrotoxicosis
Authors: Staffurth J S , Morrison N D W
Published: December 2008

(1) Enlargement of the heart was found in 35% of a group of older patients with thyrotoxicosis who had no evidence of associated heart disease. Atrial fibrillation was present in 48% of patients with cardiac enlargement and in 10% with a normal sized heart. Both complications were more common when there was associated heart disease.

(2) In patients with an enlarged heart but no associated heart disease a reduction in heart-size after treatment of thyrotoxicosis was observed in five of twenty-three who had sinus rhythm throughout, and in three of eleven who had atrial fibrillation on presentation with subsequent reversion to sinus rhythm. There was no reduction in heart size in ten who had persistent atrial fibrillation after completion of treatment. Reduction in heart size was most marked in patients who had presented with frank cardiac failure.

(3) The incidence of cardiac enlargement and atrial fibrillation both increased with advancing age but whereas enlargement was common over 45 years atrial fibrillation was rarely seen under 55 years of age. Only one of thirteen patients with an enlarged heart under 55 years had atrial fibrillation.

(4) It is concluded that enlargement of the heart may be a manifestation of thyrotoxic heart disease, that it may precede the onset of atrial fibrillation in some instances, and consequently that atrial fibrillation is not necessarily the cause of an enlarged heart in thyrotoxicosis.
Penicillin encephalopathy
Authors: Conway N , Beck E , Somerville Jane
Published: December 2008

Five patients who developed characteristic myoclonic twitching, drowsiness and convulsions due to intravenous penicillin and cloxacillin are described. Three had poor renal function. Twenty-three reported cases of penicillin encephalopathy are reviewed and the aetiology of the syndrome is discussed.
Bone sclerosis in infancy
Authors: MacCarthy Joan M T
Published: December 2008

The significance of bone sclerosis in infants and children as seen on X-ray examination is discussed.

The recognition of increased bone density during the investigation of infants who fail to thrive may not establish the diagnosis but is important in instigating further tests.

This review draws attention to the practical value of recognizing a generalized increase of bone density, especially as an incidental finding. Since the immediate reaction of growing bone to metabolic insult is limited, there is considerable overlap in the radiographic features of different conditions, but clinical and biochemical measures can then be directed towards a correct assessment.
The management of acid-base balance in children with diabetic acidosis
Authors: Kuzemko J A , Fielding D W , Hudson F P
Published: December 2008

Acid-base changes in eleven diabetic children admitted to hospital with keto-acidosis are described. Six children required intravenous sodium bicarbonate to correct the metabolic acidosis. It is concluded that immediate use of bicarbonate in these children was efficient, rapid and safe.
Acute intravascular haemolysis and renal failure due to arsine poisoning
Authors: Coles G A , Davies H J , Daley D , Mallick N P
Published: December 2008

Two men developed acute intravascular haemolysis after exposure to arsine gas in a metal smelting works. Both survived; one developed acute renal failure and required peritoneal dialysis. His renal function returned to near normal within 3 months. The probable mode of exposure has been investigated and is discussed. The toxic effects of arsine are briefly reviewed. The preventive action taken is detailed.
Degenerative diseases of the central nervous system transmissible to experimental animals
Authors: Beck Elisabeth , Daniel P M
Published: December 2008

The clinical features and the pathological changes in the central nervous system of scrapie and kuru are described and attention is drawn to the similarities between these conditions. In both, inoculation of tissues into experimental animals reproduces a similar disease after a prolonged latent period.

The transmission of subacute presenile polioencephalopathy to a chimpanzee is noted.

The work which led to the discovery of the transmissibility of these conditions is mentioned.
The significance of central venous pressure and cardiac output measurements in shock
Authors: Riordan J F , McLay W D S , Walters G
Published: December 2008

The central venous pressure changes which occur in shock syndromes vary with the aetiology and other factors.

Two methods of measuring CVP have given different results, and their advantages and disadvantages are discussed, together with an appraisal of the diagnostic and therapeutic value of such measurements.

The CVP changes produced by transfusion are related to changes in cardiac output and the value of the latter as a guide to treatment is discussed. The relationship of these measurements to clinical signs is emphasized.
The microcirculation in shock
Authors: Matheson N A
Published: December 2008

Some aspects of blood fluidity in hypoperfusion with particular reference to the important role of the red cell are discussed. Changes in different organ beds and the internal fluidity of the red cell, which is of obvious importance in capillary flow are not considered.

It is not certain to what extent the phenomena discussed are critical factors in morbidity and mortality in shock because of paucity of objective data but there are good reasons for assuming them to be of importance and for directing treatment towards their correction.

The properties of Dextran 40 applicable to the therapy of disordered blood fluidity are described.
Volume expansion and flow promotion in shock
Authors: Gruber U F
Published: December 2008

Volume replacement is the most important step in treating hypovolaemic shock.

Blood is needed when the oxygen carrying capacity threatens to fall below a critical level, but has the disadvantage of transmitting virus hepatitis. Anicteric hepatitis is about four times more frequent than the icteric form. Pasteurized plasma protein solution and albumin are free from the risk of transmitting hepatitis virus, and are good volume restorers.

Dextran 70 represents the best artificial colloid with additional anti-thrombotic properties. Dextran 40 is indicated in special situations to promote flow.

There is no proof that large amounts of Ringer solution are superior for treating hypovolaemic shock in man compared with colloids and electrolytes.
The effect of dietary sucrose on blood lipids, serum insulin, platelet adhesiveness and body weight in human volunteers
Authors: Szanto Stephen , Yudkin John
Published: December 2008

A study was made of the effect of high or low intake of sucrose for periods of 14 days in a group of nineteen apparently healthy men.

The high sucrose diet produced no change in blood levels of cholesterol or phospholipids, or in glucose tolerance, but it produced a significant rise in triglycerides in all nineteen men. In six of them, there was in addition a rise in serum immunoreactive insulin, especially during the glucose tolerance test, and these same six subjects also showed a considerable increase in weight and a significant increase in platelet adhesiveness.

There was no difference between the six subjects and the remaining thirteen in any of the other measurements, or in the diets they consumed during the experiment. The changes produced by sucrose had disappeared, or nearly so, after 14 days of normal diet.

It is suggested that the effect of sucrose in producing hyperinsulinism may be more relevant to its possible role in the aetiology of ischaemic heart disease than its effect on blood lipids. It is further suggested that only some individuals are susceptible to the development of ischaemic heart disease by dietary sucrose, and that these may be identified as those that show ‘sucrose-induced hyperinsulinism’.
The radiological investigation of urinary infections in children
Authors: Starer F
Published: December 2008

One hundred children with urinary tract infections were fully investigated radiologically. More than half showed abnormalities of the urinary tract.

It is concluded that full investigation of the urinary tract is justifiable at any age; it should be carried out in boys at the first infection, and in girls at the latest after the second infection, or if treatment did not produce the expected cure.
Vascular radiology in liver disease
Authors: Kreel Louis
Published: December 2008

Vascular radiology of the liver has increased in scope and function in recent years due mainly to the application of new techniques.

It is now possible to examine not only the inferior vena cava and the portal venous system, but also the hepatic veins and the coeliac axis and superior mesenteric artery. Hepatic vein occlusion, portal vein patency and collateral veins, as well as space-occupying lesions, can now be diagnosed with a fair degree of accuracy.

These techniques have also helped in the understanding of the altered haemodynamics of portal hypertension and can be used for treatment by intra-arterial perfusion of chemotherapeutic substances.
Obstetric radiology
Authors: Highman J H
Published: December 2008

The uses of radiology in obstetrics are described. The dangers to the foetus are described. It is concluded that with care these can be reduced and the benefits from its use may often outweigh the dangers.

The indications for pelvimetry, the technique and its interpretation are discussed.

Placentography and the use of radiology in determining maturity are also described.
Bronchoscopy and the chest X-ray
Authors: Hately W , Jones Peter , Strickland Basil
Published: December 2008

Fifty-seven cases of primary bronchogenic carcinoma with X-ray changes, but with negative bronchoscopies, have been reviewed to illustrate the limitations of this method of examination. The reasons for these limitations are discussed.
Acute carbon monoxide poisoning—3 years experience in a defined population
Authors: Smith J Sydney , Brandon S
Published: December 2008

Between 1 January 1965 and 31 December 1967, 206 episodes of carbon monoxide poisoning were known to the coroner or the city hospitals in Newcastle upon Tyne.

The mortality rates were: suicidal exposure 38·2%; accidental exposure 39·7%.

In 21·3% of suicidal and 18·9% of accidental exposures recovery was complicated by prolonged delirium suggesting that all degrees of functional or structural neurological damage may have occurred, yet oxygen therapy was given in only 43·8% of suicidal and 34·5% of accidental exposures.

In view of the risk of persistent neuropsychiatric sequelae it is suggested that current patterns of management should be revised.
Kerosene poisoning in children
Authors: Nouri L , Al-Rahim K
Published: December 2008

The epidemiological and clinical aspects of 100 cases of kerosene poisoning have been studied.

The use of gastric lavage is discussed, and it is considered that this measure is probably valuable in treatment.

The importance of preventive measures is stressed.
Clinical associations of vitiligo
Authors: Dawber Rodney P R
Published: December 2008

Vitiligo, a common skin condition, has been reported in association with thyroid disease, pernicious anaemia, carcinoma of the stomach, Addison’s disease and diabetes mellitus.

Some subjects with vitiligo can be shown to possess circulating antibodies to thyroid gland, thyroglobulin, gastric parietal cells and adrenal gland, even in the absence of disease.

Vitiligo is evidently another ‘skin-marker of internal disease’.
The aim and philosophy of patient monitoring
Authors: Stewart J S S
Published: December 2008

The history of monitoring is traced from ancient times until the invention of transducers and computers. The relevance of progress in resuscitation is emphasized.

The more recent evolution of electromedical apparatus is considered from single signal detection, display and alarm to multiple signal processing, trend analysis and diagnosis.

The aim of patient monitoring is to give warning of early or dangerous deterioration and to achieve this by obtaining an optimal compromise involving many design factors, clinical, engineering and economic.

A new philosophy is illustrated by the specification and development of the Lifeline patient monitor. The translation of clinical diagnoses into electronic switching logic is of particular importance.
Principles of engineering design
Authors: Penny R K
Published: December 2008

The paper sets out procedures used in engineering design by listing the various steps in a sequential pattern. This pattern is not universally applicable and the variants on it depend on the type of problem involved and the information available. Of critical importance is the way in which models—physical or mathematical—can be constructed and depending on these, three design methods are described. These types are illustrated by reference to a number of medical aids which have been designed.
Patient monitoring: on-line computing
Authors: Raison John C A
Published: December 2008

On-line computing represents a further extension of the senses of attendant staff in intensive care situations.

Smaller computers will contribute as scientific processors, by extending the capability of instrumental systems or enabling new means of measurement and calculation.

The fullest use of computer-aid will provide systems of data acquisition from multiple sources, rapid processing correlation, analysis in mathematical and diagnostic forms, and resultant output in simply intelligible displays: later, some direct control of therapy may be applied.
Experimental studies with a clinical monitor and diagnostic computer
Authors: Levy L S , Guruswamy B A , Lee W R , Stewart J S S
Published: December 2008

A clinical monitor and computer is described which uses input information about heart rate, blood pressure and oxygen saturation. The data are processed in a simple diagnostic computer, the circulatory failure analyser, to give a diagnosis of cardiac arrest, hypoxia and oligaemic shock and to give early warning of tachycardia, bradycardia, hypertension, hypotension and cyanosis. The analyser was tested on simulated signals and experimentally in animals. The validity of the logic utilized by the computer was confirmed and the sensitivity as a monitor was assessed.
User needs of patients and nurses in clinical monitoring
Authors: Crook J
Published: December 2008

Monitoring equipment can be uncomfortable and even painful when connected to a patient and its mere presence can produce anxiety. It is possible to reduce these effects to some extent, and by adequate explanation and reassurance to persuade the patient to accept techniques which are used in his own interest.

The nursing staff will accept and use equipment, even though it is quite complex, if they are convinced primarily that it is necessary for the patient and reliable, and secondarily not too time consuming to look after. The equipment used for monitoring at the moment is too unreliable to be accepted confidently as a warning device. There is a need for much more reliable equipment in this field, but it is unlikely that the number of nurses required for an intensive care unit could be reduced.

It is generally agreed that there is a need for a technician experienced in electronics equipment to maintain and service these machines.
Monitoring requirements in patients with acute myocardial infarction
Authors: Adgey A A Jennifer , Pantridge J F
Published: December 2008

The majority of deaths from myocardial infarction occur soon after the onset of symptoms. The mobile scheme described allows intensive care to commence in the patient’s own home or at the site of infarction and thus reduces the interval between the onset of symptoms and the initiation of intensive care. Monitoring is continued during transport and following admission to the hospital coronary care unit.

The major impact of therapy on the mortality from acute myocardial infarction will result from the detection and correction of rhythm disturbances.
Anaesthetic requirements in patient monitoring
Authors: Payne J P
Published: December 2008

The differences between monitoring the unconscious patient in the operating theatre and the semi-conscious patient in the recovery room are stressed.

In the semi-conscious patient particular difficulties arise at the patient-sensor interface and with data-handling procedures which often disturb the patient.

New methods of data processing, including the use of computers, are discussed.
Phenylketonuria: a review
Authors: Yu J S
Published: December 2008

The development of a practical screening procedure for phenylketonuria and the improvement in methods of chemical analysis have led to a realization that Folling’s (1934) disease of phenylketonuria is not a single entity.

In this commentary, the current view on some aspects of phenylketonuria will be reviewed and the problems illustrated by experience gained in the Phenylketonuria Clinic at the Royal Alexandra Hospital for Children in Sydney, at present attended by fifty-six children. From April 1964, fifty-six infants and children were referred because of a positive screening test. Six were no longer abnormal at the time of retesting, forty-two had classical phenylketonuria and eight showed an atypical pattern. Subsequent family studies revealed five other classical phenylketonuric children, all of whom were retarded, and one other atypical phenylketonuric boy.
Ocular sarcoidosis
Authors: Jackson H
Published: December 2008

In 5529 new patients attending eye clinics 0·8% of patients were found to have endogenous uveitis. None had radiographic evidence of sarcoidosis. Of thirty-four who had a Mantoux test 56% were negative. A Kveim test done on twenty-four of the cases revealed that 12·5% were positive, and in two of these histological evidence of sarcoidosis was found.

Eighty-two patients with multisystem sarcoidosis were similarly investigated and in addition their lachrymal secretion was measured. Of these twelve (14·6%) had an ocular lesion, six having bilateral uveitis, two unilateral uveitis and four lachrymal gland enlargement. 58% of these cases were found to have reduced lachrymal secretion. In addition fifty-seven of these patients without ocular abnormality had their lachrymal secretion measured and 49% of these were found to have reduced lachrymal secretion.
An attempt to demonstrate a transmissible agent from sarcoid material
Authors: Mitchell D N , Rees R J W
Published: December 2008

The results of a controlled experiment in which an attempt was made to transmit sarcoidosis by inoculation of sarcoid and non-sarcoid lymph node homogenates into the footpads of normal and immunologically deficient mice, are reported.

The early and late changes in the footpads were assessed microscopically. A substantial proportion of the footpads of mice receiving sarcoid homogenate showed the histological characteristics typical of sarcoidosis in man and evolved fully only after a period of 6-8 months following inoculation. Moreover, positive Kveim tests were confined to a proportion of those mice given sarcoid homogenates and were all associated with a sarcoid granuloma in the footpad.

Conversely, the inflammatory lesions seen in the early histology of the footpads of mice inoculated with non-sarcoid homogenate were no longer apparent in the late histology and Kveim tests in all mice given non-sarcoid homogenate were negative.
Evaluation of the clinical and histological features of paratracheal and hilar gland enlargement
Authors: Mikhail J R , Drury R A B , Mitchell D N
Published: December 2008

Sixty-nine patients with a chest radiograph showing enlargement of the hilar and/or paratracheal lymph nodes were analysed. Ten of these, mainly Asian, were found to be suffering from tuberculosis. Of the remaining fifty-nine, who had sarcoidosis, 12% were tuberculin-positive. All the cases diagnosed as sarcoidosis had either a positive Kveim test and/or mediastinal lymph node histology compatible with sarcoidosis. 10% of cases with sarcoidosis showed evidence of uveitis and 10% showed bone cysts and there was also a high proportion of other extrathoracic lesions.

From these studies we conclude that, whilst the currently accepted radiological staging of sarcoidosis serves as a convenient form of reference, these stages do not in any way relate to the clinical stage of disease, or to the histological appearance of affected lymph node tissue.

There is a correlation between a strongly positive Kveim test of three or more granulomas and mediastinal lymph nodes showing confluent granulomata (predominantly of the epithelioid cell-type) with fibrosis. The presence of intra- or peri-granulomatous fibrosis, or even gross diffuse fibrosis, does not seem in itself to be related to the nature of onset, clinical or accepted radiological staging of disease. However the mediastinal lymph nodes in patients with erythema nodosum were predominantly of giant cell-type; these patients were also Kveim-positive. Similar instances of giant cell predominance in the mediastinal lymph nodes were seen in each of the groups examined. Further studies are required to determine whether these cellular characteristics, or other histological features in the mediastinal lymph nodes, might be of prognostic significance.
Obesity and coronary heart disease
Authors: Baird I McLean
Published: December 2008

Firstly, the incidence of obesity in the United Kingdom is not accurately known at the present time. Secondly, regional studies indicate that approximately half the population is overweight. The relationship of major degrees of obesity with sudden death and angina is established. The reversibility of the rise in coronary heart disease in obese subjects after weight reduction suggests that this is an important prophylactic measure particularly in middle-aged men. Thirdly, the prospective role of exercise in preventing coronary heart disease particularly in obese subjects deserves further investigation.
L-Dopa and amantadine hydrochloride in extra-pyramidal disorders
Authors: Parkes J D , Knill-Jones R P , Clements P J
Published: December 2008

L-Dopa and amantadine hydrochloride were separately given to patients with diverse extra-pyramidal disorders including progressive supranuclear palsy; porto-systemic encephalopathy; oculogyric crises; drug-induced Parkinsonism; Huntington’s chorea, hemiballismus; spasmodic torticollis, familial tremor; and athetosis. Akinesia and rigidity were improved in the first two conditions and simultaneously there was improvement in disordered eye movement. Amantadine provoked an exacerbation in spasmodic torticollis and familial tremor. No other condition was influenced. Both amantadine and L-dopa will facilitate eye movement mechanisms: it seems probable that both drugs act on dopamine-sensitive areas within the CNS. Neither drug will give significant benefit in the above disorders.
The results of surgery for low back and leg pain due to presumptive prolapsed intervertebral disc
Authors: Dunkerley G E
Published: December 2008

Fifty-six patients who had undergone fifty-seven operations for low back and leg pain thought to be associated with a prolapsed intervertebral disc have been reviewed. Forty-two had only mild residual signs and symptoms or none at all.

The patients selected for surgery were those with intractable signs and symptoms which had not improved with conservative treatment, and some were chronic low back invalids.

Myelography is a desirable adjunct in some patients when localization or diagnosis is in doubt.

In addition to the forty-two patients who had a successful outcome, five patients were improved and five who eventually had recurrences were successful at first. The figures therefore show that some measure of relief resulted from fifty-two out of fifty-seven operations performed.

The results of operation for carefully selected patients with presumptive prolapsed lumbar intervertebral disc are good. The operation is expected to relieve leg pain but more than half the patients will continue to have some discomfort or paraesthesiae. More relief from backache occurs than might be expected in view of the pathology and nature of the surgical procedure.

Most patients can return to their former occupation even though arduous.

Those accustomed to wear low back supports for years are able to stop doing so after surgery.

A small proportion of patients with initial successful results develop recurrence of back and leg symptoms. Most subside with conservative treatment and may arise from rupture of adhesions but re-exploration is sometimes necessary.

The results after the fenestration operation were not convincingly superior to those after laminectomy. Bearing in mind that the fenestration procedure was usually done on those with clear-cut signs and positive localization, it does not appear that there is anything to be gained by doing this rather more difficult operation.
Waardenburg’s syndrome and familial periodic paralysis
Authors: Tay C H
Published: December 2008

Nine members in three generations of a Chinese family were found to have Waardenburg’s syndrome comprising, mainly, lateral displacement of the inner canthi, broadening of the nasal root and hypertrichosis of the eyebrows. Other minor features were also found.

Two patients had in addition, hypokalemic periodic paralysis of the familial type, one had prominent frontal bossing and another, bilateral cleft lips and palate. These associated anomalies have not been previously documented and the presence of two autosomal dominant genetic defects in this family is of particular interest.
Infectious hepatitis in Bristol, 1959-70
Authors: Skone J F
Published: December 2008

An outbreak of infectious hepatitis occurred in Bristol between January 1960 and January 1961.

Children between the ages of 5 and 10 years were particularly affected.

No association with Down’s syndrome, or with immunization procedures, drugs or dental anaesthetics was found.
Some aspects of the epidemiology of hepatitis in Sweden
Authors: Ringertz Olof
Published: December 2008

The incidence of hepatitis in Sweden is relatively low, but an outbreak associated with the consumption of infected oysters occurred in 1955.

Subsequently, an increasing incidence was noted among track-finders. Methods of eliminating cross-infection by traces of blood among the runners greatly reduced this incidence.

Since 1964, hepatitis associated with haemodialysis and with narcotic addiction has become common.

The changes in the epidemiological pattern during the last 20 years are discussed.
Prevention of hepatitis in dialysis units
Authors: Polakoff Sheila
Published: December 2008

The efforts that have been made to prevent outbreaks of hepatitis in haemodialysis units are briefly reviewed.

Human immunoglobulin is of doubtful value in prophylaxis.

The preliminary results of screening for Australia antigen and the prompt isolation of carriers are encouraging.
Psychological aspects of headache
Authors: Bridges P K
Published: December 2008

Headache is one of the most common symptoms encountered in clinical practice. Its conceptual problems are those of pain in general and some of the theories concerning pain, especially those attempting to relate psychological and physical aspects, are considered.

The classifications which have been suggested for headaches associated with emotional causes are described and it is shown that these are of limited clinical value. Some of the psychogenic causes of headache are considered and the associations of the symptom with various psychiatric illnesses are described. Headache is especially likely to be found with depressive illnesses. The treatments for various psychological types of headache are reviewed.
Complete heart block in patients with peroneal muscular atrophy
Authors: Ponder B A J , Chatterjee K , Sutton G C
Published: December 2008

Two patients with peroneal muscular atrophy who also had complete heart block are reported.

The pathogenesis of heart block in one of these patients was investigated by left ventricular volume analysis which showed a normal ejection fraction, indicating intact left ventricular function. This patient in addition had a normal coronary arteriogram.

These findings suggest that heart block in patients with peroneal muscular atrophy may be due to primary conduction tissue disease rather than cardiomyopathy.
Mitral valve disease, systemic embolism and anticoagulants
Authors: Fleming H A , Bailey Sheila M
Published: December 2008

Over a period of 9½ years patients in East Anglia with mitral valve disease not requiring immediate surgery have been followed.

There has been a high incidence of systemic embolism before the patients are referred.

Long-term treatment with anticoagulants appears to offer a good degree of protection to these patients and, provided the control of the treatment is good, the risks arising from it are small and less than the risks of embolism.
Factors influencing the prognosis in myelomatosis
Authors: Dawson Audrey A , Ogston D
Published: December 2008

One hundred and eighty-eight patients with myelomatosis, 166 of whom had multiple myelomatosis, were studied to assess the prognostic significance of age, sex, mode of clinical presentation, presence of anaemia, azotaemia and abnormal cells in the peripheral blood at the time of diagnosis.

The generalized disease was rapidly fatal in many of these unselected patients. Women survived longer than men and the young slightly longer than the old.

Of the laboratory findings, only a raised blood urea (greater than 60 mg/100 ml) was associated with a statistically poorer prognosis.
The use of amiloride hydrochloride in the correction of hypokalaemic alkalosis induced by diuretics
Authors: Antcliff A C , Hamilton M , Beevers D G , Harpur J E
Published: December 2008

Amiloride hydrochloride is a very potent drug for correcting the profound hypokalaemia and metabolic alkalosis that is induced by thiazide and other diuretics. No potassium supplements are necessary.
Intravenous glucose tolerance in myocardial infarction
Authors: Pearson Donald
Published: December 2008

Intravenous glucose tolerance tests were carried ont on forty patients with recent myocardial infarction and thirty-nine matched controls with recent bone injury.

Abnormal results were detected in 77·5% of cardiac patients and 68% controls. When tests were repeated after acute stress factors had settled, normal results were obtained in 85% of thirty-three cardiac subjects and 84% of thirty-eight controls.

It is concluded that the disturbance of glucose tolerance in myocardial infarction is a non-specific stress effect and should not be regarded as necessarily indicating a latent diabetic tendency.
The opportunist mycobacteria—a 20-year retrospect
Authors: Marks J , Jenkins P A
Published: December 2008

A review is presented of the incidence and distribution of infections with opportunist mycobacteria in Wales for the years 1952-71. The most important opportunist pathogen was Mycobacterium kansasii.

Although the numbers affected by each species were small, taken together they indicate a genuine increase in incidence over the two decades. As tuberculosis declined by five-sixths over the same period, the relative change has been striking.

The distribution of infections suggest that exposure to dust at work and to heavy air pollution at home predispose to infection by opportunist mycobacteria.
Laboratory aspects of intermittent drug therapy
Authors: Mitchison D A , Dickinson Jean M
Published: December 2008

The drug-parasite relationships for isoniazid and rifampicin have been investigated, using cultures of M. tuberculosis and infected guinea-pigs.

It is remarkable that there appear to be two entirely different mechanisms involved in intermittent chemotherapy with isoniazid and rifampicin. With isoniazid, any escape from the influence of the drug leads to diminished efficacy. On the other hand, with rifampicin, it is just this escape that promotes higher efficacy.
The effect of surgical operation on leg venous flow measured with radioactive hippuran
Authors: Kemble J V Harvey
Published: December 2008

The velocity of venous blood flow in the legs has been measured in patients before and after operation using 125I hippuran.

Immediately after operation there was a profound slowing of venous flow to about half the pre-operative rate. On the day following operation the rate had returned to the pre-operative level.

The effect of elevation of the legs has been investigated. Leg elevation approximately doubled the rate of flow.

The value of leg elevation as a measure in the prevention of deep vein thrombosis is discussed in the light of these findings. The paper provides evidence that the practice of elevation of the legs during and after operation increases venous flow rate.
Non-cardiac morphological stigmata of congenital heart disease
Authors: Livesley Brian
Published: December 2008

The recognition of morphological stigmata other than cardiac, which are now known to be associated with congenital heart disease, coupled with a familial occurrence, may permit diagnosis of specific cardiac lesions at a very early age.

Eleven such morphological associations have been reviewed.
Left atrial myxoma in a child diagnosed by ultra-sound
Authors: Nicholls A J S , Goodman M A , Pridie R B
Published: December 2008

A case of left atrial myxoma in a child is presented. The diagnosis was made using ultra-sound and confirmed at operation.

The results of our investigations are reviewed in the light of other authors’ experience with this disease. The use of ultra-sound in recognizing this condition is discussed.
Meniscectomy—a review of 249 cases (1963-68)
Authors: Gonet L C L , Raine G E T
Published: December 2008

A series of 249 meniscectomies is reviewed. The average time to return to work after operation was 37 days. Statistical data are provided, and observations are made on the changing epidemiology.
Low back pain: a psychiatric investigation
Authors: Wolkind S N , Forrest A J
Published: December 2008

Middlesex Hospital Questionnaire scores of a group of male patients attending a physiotherapy department for treatment of low back pain distinguished between those patients with a good and those with a poor out-outcome.

Comparing the scores of these two groups with those of a normal male population suggests that there are two distinct populations of patients with low back pain.

A questionnaire may have a place in the selection of patients who are unlikely to respond to conventional treatment for low back pain and who need extensive social or psychiatric investigation.
Thyroid nodules in Iraq
Authors: Al-Hashimi H M
Published: December 2008

Two groups of patients with solitary thyroid nodules have been analysed. One hundred patients of the first group under 20 years of age were managed conservatively with supplementary doses of thyroxin. Three hundred and thirty patients of the second group over the age of 20 were treated surgically.

Seventeen percent of the first group had complete resolution of the thyroid nodule. The majority (eighty-three patients) needed exploration for a residual lesion.

In the two groups, adenomatous goitre constituted the most frequent pathological finding. True adenoma was the next in frequency.

Malignant nodules were found in ten cases (3.0%) of the second group; none was found in the first group. The overall incidence of carcinoma in solitary thyroid nodules in this study was 2·3%.
On vaccines and vaccination: typhoid-paratyphoid fevers
Authors: Vella Wally
Published: December 2008

The various preparations of TAB vaccines proposed in the past and/or available for use at present, together with the methods suggested for the vaccination procedures, are described.

The difficulties of interpreting the serologic diagnostic tests (Widal Test) and the possible dangers of vaccination during an epidemic (provocation typhoid) are discussed.