bluuebunny/crossref_metadata_2025 huggingface dataset:
A newly designed single etalon double edge Doppler wind lidar receiving optical system
Authors: Kim Dukhyeon , Kwon Seongok , Cha Hyungki , Kim Younggi , Sunwoo Jeonghaei
Published: December 2008

A new optical Doppler lidar receiving system which can measure Doppler-shifted incoherent scattering light has been proposed and tested. This system functions in a manner similar to two edge filters and consists of a single etalon, a polarization beam splitter, and mirrors that can guide scattered light into a single etalon with two different angles. These two incident angles are precisely adjusted by the polarization beam splitter and mirrors. Using this optical receiving system we can measure a moving target with a high sensitivity. Theoretical calculations show that this system will have a better optical sensitivity than a single edge system and will allow the use of incoherent Doppler lidar for wind velocity measurements.
Benchtop time-resolved magneto-optical Kerr magnetometer
Authors: Barman Anjan , Kimura T. , Otani Y. , Fukuma Y. , Akahane K. , Meguro S.
Published: December 2008

We present here the construction and application of a compact benchtop time-resolved Kerr magnetometer to measure the magnetization precession in magnetic thin films and lithographically patterned elements. As opposed to very expensive femtosecond lasers this system is built upon a picosecond pulsed injection diode laser and electronic pulse and delay generators. The precession is triggered by the electronic pulses of controlled duration and shape, which is launched onto the sample by a microstrip line. We used polarized optical pulses synchronous to the electronic pulses to measure the magneto-optical Kerr rotation. The system is integrated in a conventional upright microscope configuration with separate illumination, imaging, and magneto-optical probe paths. The system offers high stability, relative ease of alignment, sample changing, and a long range of time delay. We demonstrate the measurements of time-resolved dynamics of a Permalloy microwire and microdot using this system, which showed dynamics at two different time scales.
Ferroelectric BaxSr1−xTiO3 thin-film varactors with parallel plate and interdigital electrodes for microwave applications
Authors: Zhang Xiao-Yu , Wang Peng , Sheng Su , Xu Feng , Ong C. K.
Published: December 2008

Columnar BaxSr1−xTiO3 (BST) thin films with x=0.25 and 0.5 were grown by pulsed laser deposition on single crystal LaAlO3 and Pt/Ti/SiO2/Si substrates, respectively. Ferroelectric varactors were then fabricated from the BST thin films by photolithographic techniques based on parallel-plate capacitors (PPCs) and coplanar interdigital capacitors (IDCs). The microstructure, dielectric constant ε, loss tan δ, tunability τ, and temperature dependent characters of the BST film with IDC and PPC electrodes were investigated and compared in a wide frequency range from 1 kHz to 10 GHz. The Ba0.5Sr0.5TiO3 films exhibited larger permittivity, tunability, and loss tan δ at the level of IDC and PPC structures compared to Ba0.25Sr0.75TiO3 films. As measured by IDC and PPC electrodes, their in-plane dielectric properties also exhibited a larger permittivity, lower loss tan δ, and relative lower tunability than that of out-of-plane dielectric properties. Finally, the influence on the dielectric properties of the columnar BST grains due to the use of different types of electrodes was discussed.
UBF levels determine the number of active ribosomal RNA genes in mammals
Authors: Sanij Elaine , Poortinga Gretchen , Sharkey Kerith , Hung Sandy , Holloway Timothy P. , Quin Jaclyn , Robb Elysia , Wong Lee H. , Thomas Walter G. , Stefanovsky Victor , Moss Tom , Rothblum Lawrence , Hannan Katherine M. , McArthur Grant A. , Pearson Richard B. , Hannan Ross D.
Published: December 2008

In mammals, the mechanisms regulating the number of active copies of the ∼200 ribosomal RNA (rRNA) genes transcribed by RNA polymerase I are unclear. We demonstrate that depletion of the transcription factor upstream binding factor (UBF) leads to the stable and reversible methylation-independent silencing of rRNA genes by promoting histone H1–induced assembly of transcriptionally inactive chromatin. Chromatin remodeling is abrogated by the mutation of an extracellular signal-regulated kinase site within the high mobility group box 1 domain of UBF1, which is required for its ability to bend and loop DNA in vitro. Surprisingly, rRNA gene silencing does not reduce net rRNA synthesis as transcription from remaining active genes is increased. We also show that the active rRNA gene pool is not static but decreases during differentiation, correlating with diminished UBF expression. Thus, UBF1 levels regulate active rRNA gene chromatin during growth and differentiation.
CLIP-170 tracks growing microtubule ends by dynamically recognizing composite EB1/tubulin-binding sites
Authors: Bieling Peter , Kandels-Lewis Stefanie , Telley Ivo A. , van Dijk Juliette , Janke Carsten , Surrey Thomas
Published: December 2008

The microtubule cytoskeleton is crucial for the internal organization of eukaryotic cells. Several microtubule-associated proteins link microtubules to subcellular structures. A subclass of these proteins, the plus end–binding proteins (+TIPs), selectively binds to the growing plus ends of microtubules. Here, we reconstitute a vertebrate plus end tracking system composed of the most prominent +TIPs, end-binding protein 1 (EB1) and CLIP-170, in vitro and dissect their end-tracking mechanism. We find that EB1 autonomously recognizes specific binding sites present at growing microtubule ends. In contrast, CLIP-170 does not end-track by itself but requires EB1. CLIP-170 recognizes and turns over rapidly on composite binding sites constituted by end-accumulated EB1 and tyrosinated α-tubulin. In contrast to its fission yeast orthologue Tip1, dynamic end tracking of CLIP-170 does not require the activity of a molecular motor. Our results demonstrate evolutionary diversity of the plus end recognition mechanism of CLIP-170 family members, whereas the autonomous end-tracking mechanism of EB family members is conserved.
EBs clip CLIPs to growing microtubule ends
Authors: Wittmann Torsten
Published: December 2008

Proteins that track growing microtubule (MT) ends are important for many aspects of intracellular MT function, but the mechanism by which these +TIPs accumulate at MT ends has been the subject of a long-standing controversy. In this issue, Bieling et al. (Bieling, P., S. Kandels-Lewis, I.A. Telley, J. van Dijk, C. Janke, and T. Surrey. 2008. J. Cell Biol. 183:1223–1233) reconstitute plus end tracking of EB1 and CLIP-170 in vitro, which demonstrates that CLIP-170 plus end tracking is EB1-dependent and that both +TIPs rapidly exchange between a soluble and a plus end–associated pool. This strongly supports the hypothesis that plus end tracking depends on a biochemical property of growing MT ends, and that the characteristic +TIP comets result from the generation of new +TIP binding sites through MT polymerization in combination with the exponential decay of these binding sites.
A Model of Farsighted Voting
Authors: Penn Elizabeth Maggie
Published: December 2008

I present a new method of interpreting voter preferences in settings where policy remains in effect until replaced by new legislation. In such settings voters consider not only the utility they receive from a given policy today, but also the utility they will receive from policies likely to replace that policy in the future. The model can be used to characterize both long‐term preferences and distributions over policy outcomes in situations where policy is ongoing and voters are farsighted.
When Can Politicians Scare Citizens Into Supporting Bad Policies?
Authors: Lupia Arthur , Menning Jesse O.
Published: December 2008

Many people claim that politicians use fear to manipulate citizens. Using a model, we examine how select attributes of fear affect a politician's ability to scare citizens into supporting policies that they would otherwise reject. In the model, the politician can alert citizens to the presence of a threat. But his claim need not be true. How citizens respond to this claim differs from most game‐theoretic models. Our representation of this response follows from research in psychology, has distinct conscious and subconscious components, and does not presume efficient processing (i.e., Bayesian updating). Our conclusions counter popular claims about when politicians will use fear to manipulate citizens. They also highlight issues (abstract, distant) and leaders (secretive) for which recent empirical findings about how fear affects politics will—and will not—generalize to other cases.
A Model of Spoils Politics
Authors: Dal Bó Ernesto , Powell Robert
Published: December 2008

Accounts of state failure in the developing world frequently highlight a logic of “spoils politics” in which a government and an opposing faction vie for control of the state and the accompanying spoils. Attempts to buy the opposition off play a key role in this logic, and an informational problem often complicates these efforts. Because of limited transparancy, the government generally has a better idea about the actual size of the spoils than the opposition does. We formalize this aspect of spoils politics as a signaling game in which the government has private information about the size of the spoils and tries to co‐opt the opposition by offering a share of the spoils. The opposition can accept the offer or reject it by fighting. Consistent with the strong empirical finding that the probability of civil war is higher when income is low, the probability of breakdown increases as the size of the spoils decreases. We also study the effects of uncertainty, the opposition's military strength, the cost of fighting, and power‐sharing agreements on the probability of fighting.
Conservation in zoo shops today and in the future: a case study and discussion
Authors: SWANNIE SIGSGAARD N.
Published: December 2008

Issues relating to current ethical and environmental trading standards and certifications, and their prevalence and relevance to zoos today, are introduced. This is followed by a case study of the Payamino community conservation project and its sustainable production of handicrafts as part of a conservation‐friendly range of ‘Zoos Go Wild’ products, distributed by HMJ Design of Denmark. The project aims to protect the high levels of biodiversity in a pristine and remote 60 000 ha territory of Ecuadorian upper lowland rainforest. Handicraft production is just one of the forms of income that the project promotes to support the sustainable development of this community, enabling it to keep oil, timber and gold companies out of its territory, and removing the need to hunt and sell illegal bushmeat. Although HMJ Design no longer distributes these or other handicrafts, it hopes that lessons can be learnt from its experiences. In light of the issues raised in the case study, a discussion then follows on how conservation and sustainability could be better integrated into and supported by zoo shops in the future.
Praecordial pulsations in health and disease
Authors: Mounsey Patrick
Published: December 2008

In a previous paper (Mounsey, 1966) the genesis of praecordial pulsations in health and disease was examined. The normal, short, outward impulse at the apex reflected underlying early systolic outward movement of the underlying ventricle as visualized in the lateral angiocardiogram. The sustained impulse of left ventricular hypertrophy was seen in the angiocardiogram to be due to failure of retraction of the antero-apical portion of the left ventricle in late systole. In cardiac aneurysm where a sustained impulse is also met, paradoxical pulsation of the aneurysm with failure of late systolic retraction accounted for the abnormal impulse.

Marked systolic retraction of the cardiac impulse was met in two important conditions, tricuspid incompetence and constrictive pericarditis. The high stroke-output of the dilated right ventricle in tricuspid incompetence with both forward and backward ejection of blood accounted for systolic retraction at the apex in this condition. In constrictive pericarditis, on the other hand, in cases where the process involves predominantly the atrioventricular groove and outflow tract regions, the relatively free surface of the anterior wall of the right ventricle may show compensatory increased movement with marked systolic retraction and diastolic expansion, themselves in turn transmitted to the praecordium.

The giant atrial beat of hypertrophic obstructive cardiomyopathy reflected increased atrioventricular transport function as was shown in the timed cineangiocardiogram.

In the present paper, details of the form of the cardiac impulse in health and disease are described. These have been recorded with an instrument measuring absolute displacement, the impulse cardiograph (Beilin & Mounsey, 1962). The impulse cardiogram aims at being a graphic record of what the physician’s hand and fingers feel.
Preoperative diagnosis of strangulated obturator hernia
Authors: Archampong Emmunuel Quaye
Published: December 2008

Six cases of strangulated obturator hernia seen over a period of 8 months in a sixty-bed surgical unit are reported. The sex ratio was five females to one male. There was no mortality.

The importance of preoperative diagnosis or suspicion of obturator hernia is stressed. In this radiology may be of help.

Treatment is briefly discussed.
A pre- and post-operative study of forty-six cases of slipped intervertebral disc
Authors: Harto-Garofalidis G , Papavassiliou N , Rigopoulos Ch , Papathanassiou B T
Published: December 2008

The results of operation on 46 cases of slipped disc have been studied.

The age of the patient and the duration of pre-operative symptoms both influence the late results.

Results were not usually satisfactory in cases with severe limitation of straight-leg raising.

Severe pressure on the nerve-root produces permanent changes and symptoms do not always disappear after its relief.

The presence of degenerative changes, visible on the radiograph, is associated with poor late results.

Tears of the posterior longitudinal ligament are associated with satisfactory late results.

In the majority of cases, the early and late results were similar.
A simplification of the knee-joint meniscectomy operation
Authors: Schwartz S
Published: December 2008

A modification of the standard meniscectomy procedure has been described to simplify the detachment of the posterior horn of the medial cartilage of the knee-joint.
Serum-insulin response to glucose in ‘pancreatic diabetes’
Authors: Bank Simmy , Keller P , Jackson W P U , Marks I N
Published: December 2008

Thirty patients with chronic pancreatitis (mostly calcific) were tested for glucose tolerance and serum insulin response to glucose loading. The responses were very variable and the insulin values did not clearly relate to the ‘glucose-tolerance-status’. Some subjects had low insulin levels throughout, some had average to high fasting levels without further response, and some showed an excellent rise of insulin level after glucose.

No antibodies to insulin could be found in seven patients. Synalbumin antagonist was present at 1·25% in five out of twelve patients tested.
A study of pre-operative sedatives
Authors: Parkhouse James , Mahoney Joan
Published: December 2008

A state-registered nurse acted as a whole-time investigator following patients through the pre-operative night in hospital and questioning them in the morning, to assess the relative merits of different medications. Two new sedatives were compared with a standard barbiturate and a placebo, and information was collected from patients who elected to have no medication to help them sleep. Subjective assessment enabled the placebo to be distinguished from the active medications, although there was little difference between these. The importance of psychological factors is discussed in relation to those patients who had no medication.
Carotid endarterectomy in cerebral vascular disease
Authors: Morris W Rex
Published: December 2008

1. The role of surgery in carotid artery disease is discussed for both transient ischaemic attacks and for completed strokes.

2. It is emphasized that surgery is essentially prophylactic and therefore best undertaken before a stroke has occurred, but it may still be of value after an infarct.
Hypothyroidism due to enzyme defects
Authors: McGirr E M , Thomson John A
Published: December 2008

Defects in thyroid hormone production, transport and utilization are classified.

Particular attention is given to inherited intrathyroidal defects in hormone synthesis which impair thyroid function and lead to goitre formation and hypothyroidism. Anomalies in biosynthesis may also result from disease or drugs.

Reference is made to the derangement of iodine metabolism that results from iodine deficiency and from insufficient TSH.

Illustrative clinical problems with regard to transport and utilization are quoted, and it is inferred that they lie in rather neglected areas.

Throughout an attempt has been made to show how the clinical problems that are encountered in practice may, by the techniques of investigation available to us, be related to the theoretical list of defects that are included in the classification.
Arteriography of the coeliac axis and superior mesenteric artery in five cases of haemochromatosis with particular regard to the pancreatic circulation
Authors: Scuro L A , Curri G , Monti G , Zuin R , Romani S
Published: December 2008

Arteriography of the coeliac axis and superior mesenteric artery in five patients with haemochromatosis revealed a constant deficit of pancreatic vascularization as shown by reduced visualization of the arterial circle. These consistent results appear to be significant. There was no correlation between the existence and severity of diabetes mellitus and the pancreatic vascular involvement.
Present treatment of breast cancer
Authors: Grogono J L
Published: December 2008

Fifty surgeons and ten radiotherapists were asked to advise treatment in various hypothetical cases of breast cancer. The thirty-nine replies are analysed, and show very wide variation, both in the extent of direct surgical attack, and in the various adjunctive measures. The results of long-term controlled trials may eventually produce more uniform patterns of treatment.
Propranolol in hypertension
Authors: Tewari S N , Grant R H E
Published: December 2008

Twenty-four hypertensive patients, eleven of whom had angina pectoris as well, have been treated with propranolol in doses up to 400 mg daily. The thirteen patients without angina received methyldopa 2 g daily in addition to propranolol. A significant reduction of systolic and diastolic blood pressure was found in both groups.

Results from other authors are discussed.
Blindness after cardiac arrest
Authors: Sabah A H
Published: December 2008

Three cases of isolated blindness after cardiac arrest are described.

Blindness was associated with normal pupillary light reflexes and no observable changes in the fundi, features identifying it as cortical.

Possible mechanisms have been discussed. It is suggested that this complication is more common than has been reported in the literature.
Contrast radiography of the nasopharynx
Authors: Evison Gordon
Published: December 2008

A technique of contrast radiography of the nasopharynx is described and indications for the procedure are reviewed. The main advantage of using this method is the simple and effective way it outlines the tumour mass and shows its response to therapy and any localized recurrences. Characteristic features of tumours at different sites are illustrated. The potential usefulness of this technique in detecting early lesions is emphasized.
Hard and soft osteo-arthritis
Authors: Broad C P
Published: December 2008

This short paper attempts to show how the X-ray appearance influences the choice and success of operative procedures performed on the hip and knee joints for osteo-arthritis. If the bones look ‘soft’ the only methods likely to succeed are those in which total replacement coupled with the use of cement ensure firm anchorage and wide distribution of stress. When bones look ‘hard’ simpler methods are usually satisfactory.
Nephropathy and viroses
Authors: Reimann Hobart A
Published: December 2008

The kidneys often are involved during viral diseases, but seem to be peculiarly resistant to injury in contrast to other organs and tissues. They rarely bear the brunt of infection. Clinical evidence of viral nephritis or nephrosis seldom is of serious import and when it occurs it may be indistinguishable from that of other cause unless specific diagnostic criteria are fulfilled. With increasing interest in the subject, as happens in other circumstances, more evidence of acute or chronic viral injury to the kidneys no doubt will accrue.

Viral infections associated with renal disturbance

[Table: see text]
Adult nephrotic syndrome in Ibadan, Nigeria: a prospective study of 135 cases
Authors: Akinkugbe O O , Hunton Mollie
Published: December 2008

One hundred and thirty-five adult patients admitted into the medical wards with the nephrotic syndrome have been studied over a period of 3 years.

The histopathology in eighty-one renal biopsies showed predominantly proliferative glomerulonephritis.

Nine patients had filariasis and in six of these the microfilaria isolated was Loa loa. Six patients had malarial parasitaemia; of these, three had P. malariae infection. Urinary schistosomiasis was diagnosed in four patients.

Twenty-seven patients were noted to be hypertensive and 104 patients had some degree of impairment of renal function. A total of nine deaths was recorded (6·7%) in the 3-year period.

The significance of these results is discussed.
Antral function in duodenal ulcer
Authors: Tovey F I , Parker K , Swaminathan M , Daniell A
Published: December 2008

A dye-dilution technique is used to compare the concentration and output of acid, chloride and pepsin in duodenal ulcer patients and controls following stimulation of the antrum with alcohol, sodium bicarbonate and peptone with the response to insulin hypoglycaemia and maximal histamine stimulation.

The mean secretory rate was higher in response to all the stimuli in duodenal ulcer patients except to sodium bicarbonate.

Following antral stimulation by peptone and sodium bicarbonate the acid and chloride concentrations rose to very high levels. The mean outputs were the same as those following maximal histamine stimulation although there were wide individual variations. There was no difference between duodenal ulcer patients and controls. The ‘neutral chloride’ concentration was much less than in the other phases.

The basal secretion and the secretions in response to insulin and histamine stimulation showed higher concentrations, as well as higher outputs of acid and chloride in duodenal ulcer patients.

Pepsin concentration in response to the various stimuli showed no difference between duodenal ulcer patients and controls and the pepsin output reflected the changes in secretory volume.
Blunt abdominal trauma treated in an intensive care ward
Authors: Arthur G W , Lane B E
Published: December 2008

Seventy-two cases of major abdominal trauma with an overall mortality of 29% are reviewed. Only cases of sufficient severity to require nursing in an intensive care unit are included.

The incidence of injury to the various viscera is shown.

Methods of diagnosis and treatment are discussed.

The causes of death in this series are analysed and ways of lowering the mortality figures outlined.
The epidemiology of sarcoidosis
Authors: Hall G , Sharma O P , Naish P , Doe W , James D Geraint
Published: December 2008

The nationality, social factors, exposures, morbidity, mortality, and hospital discharge notes have been analysed in a series of patients with histologically proven sarcoidosis, and correlated with clinical and radiological features.

Compared with the expected prevalence according to the Central London population obtained from the 1961 Census, Irish and West Indians attended the Sarcoidosis Clinic twice as frequently as British, whereas African Negroes are under-represented.

Sarcoidosis is slightly commoner in women, particularly those in the childbearing years of life.

Mass miniature radiography rates per 100,000 population reveal prevalence rates of twenty overall, forty-three in those aged 25-34 years, and ten in those aged over 45 years.

Erythema nodosum, other skin lesions, and ocular involvement occurred twice as often in women.

The death-rate of about 1·7/106 population is slightly higher in women and in those living in rural districts.

Hospital discharge rates are about three per 100,000 people at risk each year.
Total fasting, hyperuricaemia and gout
Authors: Runcie J , Thomson T J
Published: December 2008

Hyperuricaemia occurred in forty-two obese subjects treated by total fasting.

This was apparently harmless in that it did not lead to acute gout in any patient, including one male known to be a sufferer from gout.

The relationship between hyperuricaemia and the acute arthropathy of gout is discussed.
Treatment of Gram-negative infections in patients before and after renal transplantation
Authors: Leigh D A
Published: December 2008

Sixty-six Gram-negative infections, occurring in thirty-four patients before and after human cadaveric renal transplantation, were treated with either gentamicin or carbenicillin. All patients were difficult chemotherapeutic problems and many were receiving immunosuppressive therapy. The majority of the infections occurred either in the urinary tract or in the peritoneal cavity following dialysis.

Laboratory studies with gentamicin showed that 98% of the strains of Gram-negative bacilli from this group of patients were sensitive to 5 μg/ml. Seventy-seven per cent of all Gram-negative bacilli were sensitive to 100 μg/ml of carbenicillin.

The outcome of treatment was found to depend on the presence of an underlying abnormality. An overall cure rate of 75% was achieved in simple infections but where the infection was complicated by an underlying abnormality the rate fell to 45% and reinfection was very common (67%). There was no significant difference in the cure rate obtained with gentamicin or carbenicillin.

Acute toxic effects due to gentamicin were seen in one case but many patients died before assessment was possible. No toxic effects were seen with carbenicillin treatment but intramuscular injections often caused local pain.

Gentamicin and carbenicillin are two valuable additions to the antibiotics available for the treatment of Gram-negative infections. The success of treatment in these infections, however, will depend on the accessibility of the primary focus of infection to the antibiotic and the nature of the underlying abnormality.
The later clinical course of haematemesis
Authors: Shafar J , Midgley J P
Published: December 2008

A study was conducted on the natural history of haematemesis in patients with peptic ulcer and in those with negative radiological examination, the bleed having occurred at least 5 years previously; excluded were those who had undergone emergency or interim surgery.

No significant difference was found in the average severity of the bleed between the ulcer and non-ulcer groups, which were comparable in age-distributions.

Routine follow-up after the haemorrhage was discontinued following correction of the post-haemorrhagic anaemia; the present haematological status was found to be satisfactory in the very great majority and it appears that the acute bleed bears little if any relationship to the process of chronic blood loss.

Physical examination and liver function tests revealed no evidence of delayed hepatic damage ensuing as a consequence of transfusion.

Recurrent haemorrhages occurred in similar proportions in the ulcer and non-ulcer groups; they revealed no particular time interval or features of significant distinction from those of the initial bleed.

Persistence of dyspepsia showed no correlation with a bleeding tendency.

There is a preponderance of blood group O in the ulcer and non-ulcer bleeders.

The radiological presence of a peptic ulcer does not necessarily indicate that this is the source of the bleeding and it is suggested that the comparable features of the select group of ulcer cases of our series and the non-ulcer cases offer support to the view that the origin of the bleed in a fair proportion of instances is common to the two groups; the possibility of a derangement of the microvasculature as the operating mechanism is mooted.
Defibrination syndrome
Authors: Ata M
Published: December 2008

Three cases of defibrination syndrome and bleeding tendency are described. In each case the aetiology was completely different but thrombocytopenia and fibrinogenopenia were present together. This combination is invariably due to diffuse intravascular clotting and it is suggested that these simple investigations should be asked for in cases of unexplained shock, acute renal failure of obscure origin, severe intravascular haemolysis, septic abortions, etc.

Heparin would appear to be of value in these cases of defibrination.

However, if there is no thrombocytopenia, defibrination may be due to excessive fibrinolysis. This should be treated with anti-fibrinolytics only when an underlying clotting defect has been excluded.
Progress in asthma
Authors: Palmer K N V
Published: December 2008

Bronchial asthma is a serious disease which carries a potential threat to life. Deaths from asthma have risen alarmingly in Britain in recent years in spite of the availability of powerful drugs to combat the attack. Overdosage from pressurized aerosols containing isoprenaline is common and is undoubtedly a factor in the rise in asthma deaths by causing fatal cardiac arrhythmias. Corticosteroid drugs in large doses are needed in all severe exacerbations of asthma and failure to respond to this group of drugs, especially when the arterial carbon dioxide tension is rising, is an urgent indication for assisted ventilation.
Herpes encephalitis
Authors: Campbell A M G
Published: December 2008

The three forms of herpetic encephalitis have been outlined and particular stress has been laid on herpes simplex encephalitis, which accounts for a large percentage of cases showing necrotizing encephalitis.

The possible application of antiviral drugs such as idoxuridine in the treatment of this disease has been mentioned.

A case of herpes B encephalitis contracted from a monkey bite has been described, and care in the handling of monkeys has been stressed.
Para-infectious and post-vaccinal encephalomyelitis
Authors: Croft P B
Published: December 2008

The incidence of encephalomyelitis in association with acute specific fevers and prophylactic inoculations is discussed. Available statistics are inaccurate, but these conditions are of considerable importance—it is likely that there are about 400 cases of measles encephalitis in England and Wales in an epidemic year.

The pathology of these neurological complications is discussed and emphasis placed on the distinction between typical perivenous demyelinating encephalitis, and the toxic type of encephalopathy which occurs mainly in young children.

The clinical syndromes occurring in association with measles, chickenpox and German measles are considered. Although encephalitis is the most frequent complication, myelitis and polyradiculitis also occur. There is evidence that ‘uncomplicated measles’ is associated with brain involvement in the prodromal phase. Similar para-infectious disorders occur in association with other infections including smallpox and influenza.

The post-vaccinal types of encephalomyelitis are also considered with particular reference to post-vaccinial encephalitis and rabies post-vaccinal encephalitis.

The pathogenesis of these disorders is discussed and it is concluded that there is direct viral invasion of the nervous system, followed by an antigen-antibody reaction. At times virus may remain latent within the nerve cell without destroying it.
Subacute sclerosing panencephalitis: measles encephalitis of temperate evolution
Authors: Dayan A D
Published: December 2008

Subacute sclerosing panencephalitis is a rare disorder of late childhood and early adolescence Affected patients usually show behavioural and intellectual disturbance and involuntary movements before dying in coma after about 12 months. At some stage most have characteristic electroencephalographic abnormalities. Pathologically, changes in the brain are those of subacute encephalitis with a variable gliosis of the white matter, and sometimes intranuclear inclusion bodies in neurones and glial cells.

Recent studies in many patients have shown high levels of circulating anti-measles antibodies, measles antigen in cells in the brain, and sometimes, myxo-virus filaments in cells there. These findings suggest that SSPE may be a slow measles virus infection of the nervous system. Possible explanations for the slow evolution of the encephalitis include disordered immune mechanisms and intracellular persistence of virus in a defective phase.
Circulatory patterns in clinical shock
Authors: Walters G
Published: December 2008

The term ‘shock’ is used to denote a pathological process, but in clinical practice it must be recognized by clinical methods.

Successful treatment requires both the haemodynamic abnormality and also the causal disease to be defined.

Because of the dynamic nature of the shock process and the multiplicity of the precipitating causes the clinical signs vary with time and also from case to case. Nevertheless, certain broad patterns tend to occur and their relationship to diagnosis and treatment are discussed.
Endotoxin shock—distinct entity or universal accompaniment?
Authors: Mee W M
Published: December 2008

If an experimental animal is subjected to graded hypotension by bleeding into a reservoir, it will usually recover if the shed blood is returned to the circulation within 2 hr. If hypotension (40 mmHg) is prolonged to 6 hr, most of the animals will die despite the return of all the blood to the circulation at the end of this period. Fine and his co-workers have suggested that this state of irreversible shock is due to endotoxaemia. Fine’s evidence in support of this thesis is presented and discussed together with apparently contradictory evidence from other sources.
Sympatho-adrenal hyperactivity—the key to irreversible shock?
Authors: Irving M H
Published: December 2008

There would appear sound evidence on which to incriminate sustained sympatho-adrenal hyperactivity as a deleterious factor of prime importance in hypovolaemic shock. The use of sympathomimetics in the treatment of shock of this type is irrational and deleterious. Their rational use in those few cases of clinical shock where they are indicated will have to await knowledge of plasma catecholamine levels in such cases.

Experimental studies involving α- and β-adrenergic blockade, unilaterally and in combination, have revealed that, contrary to previous theories, deterioration is mediated through both receptor types.

Many of the current concepts of the pathophysiology of shock will need reassessment in the light of as yet unappreciated facets of catecholamine activity.
Haemovascular changes in septic shock
Authors: Litton A
Published: December 2008

In refractory hypotension of doubtful origin, bacterial factors should be suspected and blood cultures taken. Gram-negative organisms accounted for the majority of cases of bacteraemia.

Unlike haemorrhagic shock, the blood volume estimated in patients in shock associated with infection was not found to be reduced.

In some patients, when vital signs became stabilized, a marked expansion in the vascular capacity was demonstrated.

Plasma of patients in bacteraemic shock was markedly vasoconstrictor.

The metabolic acidosis present in cases of septic shock was due to lactic-acidaemia.

Sepsis can be suspected when thrombocytopenia is associated with leucocytosis.
The effect of environment on the response to injury in the rat
Authors: Stoner H B
Published: December 2008

Recent work on the effect of changes in the environmental temperature on the local and general response to injury is discussed.

Both the acute and delayed responses to injury are affected by changes in environmental temperature.

Thermoregulation in the rat is impaired by an injury and there is an optimum temperature for survival after the injury.

The acute response to injury in the rat is also affected by the animal’s previous environmental history.

The increased sensitivity to catecholamines produced by cold acclimation alters some of the initial responses.
Shock and active vasodilatation in skeletal muscle
Authors: Walder D N
Published: December 2008

The vasodilatation which occurs in the skeletal muscle of the cat following the stimulation of some fibres of the sympathetic nerves and that which follows the intravenous injection of small doses of adrenaline takes place in different vessels. It is, therefore, possible to obtain an augmented effect when both the above stimuli are applied simultaneously. Both mechanisms must be blocked to completely abolish active vasodilatation in skeletal muscle.
The role of the liver in the development of lactic acidosis in low flow states
Authors: Schröder R , Gumpert J R W , Pluth J R , Eltringham W K , Jenny M E , Zollinger R M
Published: December 2008

The role of the liver in lactate metabolism in an experimental low flow state induced by cardiac tamponade was investigated in dogs.

Arterial and venous lactate, and pyruvate levels and arterio-venous oxygen content differences were measured for the liver, gut, forequarter and hind limbs. Cardiac output and regional blood flows were determined by electromagnetic flow probes.

The contribution of the liver to the development of lactic acidosis was found to be variable. When hepatic oxygen consumption was decreased, the liver was documented as the major site of lactate production with an associated increase in the lactate-pyruvate ratio of hepatic venous blood. In some experiments, however, the hepatic oxygen consumption was maintained, or even increased slightly; in these circumstances the liver was, in part, responsible for the development of lactic acidosis by impaired lactate consumption.
Sugar intake, serum insulin and platelet adhesiveness in men with and without peripheral vascular disease
Authors: Yudkin John , Szanto Stephen , Kakkar V V
Published: December 2008

Both the level of serum insulin and the adhesiveness of platelets are correlated with sucrose intake in men with peripheral vascular disease. These correlations do not exist in men who have no signs or symptoms of the disease, or of predisposing conditions such as hypertension.

The results support the suggestion of Szanto & Yudkin (1969) that an habitual high intake of sugar raises the insulin level in some individuals but not all, and that these individuals are susceptible to the effect of sucrose in producing occlusive arterial disease.
Barbiturate automatism—myth or malady?
Authors: Aitken R C B , Proudfoot A T
Published: December 2008

Patients admitted to the Regional Poisoning Treatment Centre at the Royal Infirmary, Edinburgh, were assessed to identify cases of drug automatism and those who denied the act of self-poisoning.

Only two out of 994 instances of poisoning could be attributed to barbiturate automatism. The case histories of these patients are reported.

Twenty-nine patients on thirty-one admissions denied the act of self-poisoning and clinical data on this sample are reviewed.

It is suggested that there is insufficient evidence for accepting barbiturate automatism as a clinical entity and that the failure of these patients to remember the ingestion of more than a therapeutic dose is the result of psychogenic defence mechanisms.

It is concluded that the use of the term automatism contributes nothing to the management of patients poisoned with these drugs.
Fractures of the femoral shaft in children
Authors: Burwell H Nevile
Published: December 2008

A series of 133 fractures of the shaft of the femur in children (during the first 12 years) is discussed. The injury is much more common in boys. The highest incidence is in 3-year-old children.

A gentle reduction is desirable and anaesthesia is rarely necessary.

In the age group under consideration ½ in. of shortening in reduction is desirable; angulation should be avoided.

Initial immobilization in younger children on Bryant’s traction and in older children on a Thomas’ splint has been found satisfactory.

The application of a plaster spica after 2 or 3 weeks allows the child to return home and in this way saves hospital beds. Physiotherapy is not required.

Complications should be avoided particularly with good nursing care but regular observation for vascular impairment (particularly after traffic accidents) is necessary.

The management of this injury is usually uncomplicated and provides good experience for junior medical staff under supervision.
Clinical use of the hyperbaric oxygen bed
Authors: Ashfield R , Drew C E
Published: December 2008

The Vickers hyperbaric oxygen bed is described and details of its use are given in the treatment of 207 patients with a wide variety of clinical conditions. As part of a deliberate policy, a special study was made of its place in the treatment of severe acute myocardial infarction.

No major procedural difficulties were encountered. Results are generally encouraging and frequently of dramatic benefit.
Intestinal electrical activity: a means of assessing viability
Authors: Archampong E Q , Reinis Stanislav
Published: December 2008

Experiments on ten dogs confirm the impression that electromyographic activity is an important criterion of viability of the intenstine subjected to vascular insults.

In all animals gangrene occurred only with complete loss of electrical activity; minimal activity (0·3 mV) was compatible with recovery.

For acceptance in clinical practice it will be essential to prove by further experimental work that an electrically inactive bowel is indeed gangrenous.
Nasal polyposis
Authors: Brown Gerald A
Published: December 2008

A review of 313 cases of nasal polyposis indicates that there is a high incidence of recurrence in this disease. Other nasal pathology affects a significant number of these patients. Simple surgical removal of the polypi by a transnasal route is the common mode of treatment.
The cavity electrocardiogram in emergency artificial pacing
Authors: Chatterjee K , Layton C A , Sutton Richard , Edwards Ann
Published: December 2008

Effective temporary pacing was achieved using the cavity ECG as a guide in twenty-five of twenty-six patients, twenty of whom were too ill to be moved to the fluoroscope.

In all patients U.S.C.I. unipolar or bipolar electrodes were used and in eleven patients this method of pacing was applied during resuscitation; four patients survived to leave hospital.

This technique is described and is recommended for emergency pacing when a bedside image intensifier is unavailable.
Exchange and simple transfusion in sickle-cell diseases in pregnancy
Authors: Buckle A E R , Price T M L , Whitmore D N
Published: December 2008

The management of sickle-cell crisis in a pregnant patient by exchange transfusion is described, the procedure leading to immediate and dramatic improvement in the condition.

Partial exchange transfusion in three other patients with sickle-cell anaemia, judged by episodes of crisis in previous pregnancies to be at particular risk, is also reported and the value of this method of management discussed.
Renal scintiscanning. A review
Authors: Davies E Rhys
Published: December 2008

Renal scintiscanning is a simple investigation that does not require special preparation and is well tolerated by patients.

Radiopharmaceuticals used in linear scanning are accumulated in the renal cortex. This accumulation is diminished: (a) when the cortex is destroyed, e.g. by pyelonephritis, injury, etc.; and (b) when the amount available to the cortex is reduced, e.g. by ischaemia. The scintigram depicts the kidneys unimpeded by bowel contents, gives a qualitative assessment of renal function and shows the distribution of zones of normal function. Recent technical improvements show great promise in deriving a quantitative measure of renal function in some circumstances.

The location of normally functioning cortex is often important in the management of renal diseases and the value of scintiscanning is then considerable. It is occasionally useful in planning surgery.

The anatomy of the renal collecting system can be shown only by urography. High dose techniques achieve this even in the face of renal failure, and scintiscanning has few indications in investigating lesions that distort the renal anatomy, e.g. tumours and cysts.

Renal scintiscanning is a very valuable additional method to urography, arteriography and renography in investigation of renal disorders.
Glomerular lesions in acute tubular necrosis
Authors: Handa S Paul
Published: December 2008

Infraglomerular epithelial reflux has been described as an early microscopic lesion in the kidney of patients with acute renal failure. In our series of forty-four cases of acute tubular necrosis none showed this finding; however, in two cases lesions remotely similar to infraglomerular epithelial reflux and often known as ‘glomerular masses’ were present. No significance can be attached to these lesions.
Neurology in India
Authors: Saunders Michael
Published: December 2008

Neurology in India is very different from the speciality practised in this country mainly because of the environment and the many geographical differences in disease-incidence.

Most of the traffic in postgraduate training has been from east to west; perhaps it is time that opportunities arose for this situation to be reversed.
Pseudoxanthoma elasticum
Authors: Tay Chong Hai
Published: December 2008

Eight cases of pseudoxanthoma elasticum seen in a Medical Unit in Singapore are described. Of these six belonged to one family.

The clinical presentations of these cases, especially the first case who was a diagnostic problem for 5 years, are described. Transmission in this family is autosomal-recessive.

Eye changes were absent. Skin lesions were minimal and the axillary folds were more involved than the skin of the neck.

Of the eight cases, three were asymptomatic except for cutaneous lesions, three had suffered a haemetemesis and four a haemoptysis, while three had mental changes, and two had cerebrovascular involvement. Case 1 had in addition, bleeding from the nose, urinary tract and uterus. She also had a fatty liver, peripheral neuropathy and hysterical fits.

Only one case presented as a cosmetic problem.

The pathogenesis of PXE is discussed; the primary defect is believed to be in the elastic and not the collagenous tissue.
Enzymes for trauma
Authors: Miller Russell R , De Young Dirk V , Paxinos James
Published: December 2008

We will discuss the mechanism of action, efficacy and side-effects of the proteolytic enzymes. Their exact mechanism of action remains vague which may be partly responsible for the uncertainty about their therapeutic value.

Use of chymotrypsin (Alpha-Chymar) in lens extractions has gained general acceptance and the topical use of trypsin-chymotrypsin (Biozyme), streptokinase-streptodornase (Varidase) and fibrinolysin-desoxyribonuclease (Elase) will also be shown to be of some value.

The merits of oral, buccal or intramuscular administration, however, will not be conclusively demonstrated. Studies showing favourable results for non-topically administered enzymes are not completely acceptable, primarily due to the lack of precise techniques of measurement.

The effectiveness of systemically administered preparations of proteolytic enzymes as anti-inflammatory agents will remain to be established.