bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Reaction and Regeneration of Cementum in Various Pathological Conditions
Authors: Stones H. H. 
Published: July 2019

(1) The reaction of cementum and its adjoining tissues to induced pathological conditions associated with the gingival sulcus is described. (2) After subjecting the sulcus to interference, its histological appearance is compared with that of definite parodontal disease. (3) Various methods were adopted for these experiments, which were performed on monkeys. (4) Artificial pockets were produced by detaching the subgingival epithelium and underlying connective tissue from the cementum. Results: ( a) Cementum is easily removed accidentally, when scraping monkeys' teeth. ( b) Reattachment of connective tissues to cementum is effected, but is usually incomplete. ( c) Epithelium always firmly reunites with cementum. ( d) The artificial sulcus which is usually deeper than normal does not show, microscopically, the same pathological changes as in parodontal disease. (5) In other experiments, in addition to deepening the sulcus, the cementum lining the pockets was also removed, leaving denuded dentine in contact with the connective tissue. A similar condition was achieved by another method in which a dental bur was inserted between two teeth below the gum margin. Results: ( a) The gingival epithelium is capable of forming a weak attachment to the dentine, though this does not usually occur. It always proliferates down and unites with the nearest layer of cementum. It seems to have a peculiar affinity for this tissue. ( b) Underlying connective tissue does not usually unite with the dentine. When this happens it is effected by the regeneration of cementum, this new tissue being lined by new cementoblasts. ( c) The width of the periodontal membrane, which was increased by the experiment, is reduced to a more normal level by deposition of new alveolar bone, and to a lesser extent by regeneration of cementum. ( d) In this series of experiments the artificial pocket is permanent and somewhat resembles that of parodontal disease. This is probably due, not so much to the injury, but to its effects creating a space which forms an area of chronic stagnation.
The Innervation and Vascular Supply of the Antrum
Authors: Strong Cecil 
Published: July 2019

An attempt has been made to obtain information about the condition of the pulp of teeth, immediately below the bony incision, made in the lateral antral wall in radical antrotomy, and to investigate the conditions obtaining in the vascular supply of that neighbourhood. The investigation has two parts: (1) Experimental; (2) Clinical. Experimental.—( a) Injections of specimens of the superior maxillæ were made with lipiodol, then X-rayed. These showed vascular anastomoses along the antral floor. ( b) Sections of the lateral antral wall and floor were cut and stained to show nerves and blood spaces. ( c) The external carotid artery was injected with Prussian Blue and the maxilla then removed. ( d) Transverse sections of the teeth denervated were cut and their pulps examined. Clinical.—The patients who had been submitted to operation were taken, and their teeth examined by:— ( a) Transillumination. ( b) Percussion. ( c) Thermal tests. ( d) Faradic currents. ( e) Radiography. From these investigations it appears that the teeth are denervated but not devitalized by the trauma to the lateral antral wall above their apices. Their blood-supply is still present, and probably comes through a collateral anastomosis, along the antral floor and partly through the antral mucosa.
Therapeutics with Hormones of the Ovary
Authors: Kaufmann C. 
Published: July 2019

The proliferation of the endometrium in the first half of the normal cycle is caused by the follicular hormone. The transformation into the secretion phase in the second half is caused by the hormone developed by the yellow substance of the corpus luteum. The term “menstrual” bleeding must be preserved for the discharged endometrium which has been proliferated first by the follicular hormone, and then transformed into the secretion phase (pregravid phase) by the corpus luteum hormone. The growth of the uterus in childhood and its pubescence depends on the follicular hormone (vegetative activity of the ovary), just as does the preservation of turgor in the genitals of the puberal woman. Many years ago, cyclic genital activity in the castrated animal was first produced by the injection of hormone, and this effect is now employed as a test for ovarian hormones. I succeeded eighteen months ago in producing complete menstruation in the castrated woman. The size of the doses of ovarian hormones administered is the important factor. In numerous experiments I have shown that—according to our present conceptions—very large doses of follicular hormones are required to produce the proliferation phase of the endometrium. The required dose is about 200,000 mouse units (= 1 million international units). For transformation of the proliferated endometrium into the secretion phase, 35 rabbit units of corpus luteum hormone are needed. The doses of follicular hormones up to now employed in therapeutics do not exert any traceable influence on the endometrium of the castrated woman. Neither have I noticed, that with doses of 600 or 1,000 mouse units, a shrivelling of the uterus which is due to long lasting functional troubles may be done away with. I have therefore proceeded to treat serious hormonal affections of the ovaries with very large doses of ovarian hormones. This paper reports on: ( a) The effect of the follicular hormone on the hypoplastic uterus, in primary and secondary amenorrhœa; ( b) spontaneous regulation of the cycle in secondary amenorrhœa also after treatment; ( c) the treatment of symptoms produced by castration and at the climacteric; ( d) the treatment of genital bleeding with corpus luteum hormone.
Diaphragmatic Paralysis: A Critical Review of its Use as a Therapeutic Measure in Respiratory Disease
Authors: Campbell A. J. 
Published: July 2019

Diaphragmatic paralysis first suggested as a therapeutic measure in lung disease by Steurtz (1911), who did simple phrenicotomy. Felix (1922) showed in 25% of cases this was ineffective owing to the presence of an accessory phrenic, and suggested phrenic exairesis, i.e. complete evulsion of the phrenic nerve. Goetze (1922) suggested radical phrenicotomy, i.e. division of the phrenic and excision of the nerve to the subclavius. Effects of diaphragmatic paralysis.—The diaphragm rises to the full expiratory position (4–8 cm.). Paradoxical movement (Kienböch's phenomenon) on affected side. Muscle atrophies. Collapse of the lung produced, affecting base and apex also. Lung volume reduced by ⅙th to ⅓rd. Physical signs.—Indrawing of the epigastrium. Thoracic breathing. Litten's sign absent. Less resistance to abdominal palpation on affected side. Diminished resonance at border of sternum and at base. Deficient inspiratory murmur at base. Radiography.—Paradoxical movement. Bittorf's test. Indications.—(A) Pulmonary tuberculosis. I. As the sole therapeutic measure. (1) In cases where pneumothorax has failed. (2) For relief of symptoms such as: ( a) hæmoptysis; ( b) cough; ( c) tachycardia ( d) nausea and vomiting; ( e) pain; ( f) hiccup. II. Combined with pneumothorax. ( a) For basal adhesions; ( b) alternative to bilateral pneumothorax; ( c) to lengthen interval between refills; ( d) at conclusion of pneumothorax treatment. III. Combined with thoracoplasty. (B) Other diseases. Unresolved pneumonia, fibrosis of the lung, bronchiectasis, abscess of the lung, hydatid disease.
The Estimation of Fœtal Maturity by a New Method of X-ray Cephalometry: Its Bearing on Clinical Midwifery
Authors: Reece L. N. 
Published: July 2019

A plea is made for routine use of X-rays in antenatal work. A new method of cephalometry is described, depending on the fact that the fœtal head is a rough ovoid. It is shown that the shadows cast by ovoids may be oval or circular, but that always the diameter of the greatest circular section of an ovoid is represented in its shadow—by the diameter if the shadow be circular or by the short axis if oval. The results are applied to estimate the actual proportions of fœtal head and maternal pelvis, and also to estimate fœtal maturity. The accuracy of the method of cephalometry was tested in 100 cases of labour induced by rupture of membranes. A simple method of pelvimetry is described, and it is suggested that pelvimetry should be carried out in the early months and not later when the pelvis is obscured. No special apparatus is required and any cottage-hospital X-ray set will serve.
The Glands of the Stomach in Relation to Pernicious Anæmia; with Special Reference to the Glands in the Pyloric Region
Authors: Meulengracht E. 
Published: July 2019

The researches have had in view the anatomical localization of the anti-anæmic factor (Castle's “intrinsic factor”) in the stomach.As the pig's stomach is peculiarly constructed, having a so-called cardiac-gland region, a fundus-gland region and a pyloric gland region continued in the glands of Brunner in the duodenum, preparations have been made from each of these regions, and tests of the effectiveness of each of these separate portions have been made in cases of pernicious anæmia. It has previously been pointed out (Meulengracht and Schiødt) that the production of hydrochloric acid, pepsin and rennin was confined to the glands of the fundus region (peptic glands) with their oxyntic cells and chief cells.The experiments showed that the extract of the fundus-gland portion was inactive in cases of pernicious anæmia, that of the so-called cardiac-gland portion was mildly active, that of the pyloric-gland portion was strongly active, and that of the duodenal portion was also strongly active. The feebler activity of the cardiac portion might be shown to be a result of the smaller number of glands to the unit area in that region.The conclusion drawn from the experiments is that the so-called cardiac glands, the pyloric glands and the Brunner glands in the duodenum, which anatomically may be said to be very nearly identical, may also be taken to be functionally identical, at any rate with regard to the production of the anti-anæmic factor.This collective gland region, which it is proposed to call the pyloric-gland region, is the site of the production of the anti-anæmic factor. There is thus attributed to these glands a definite, well-defined and vitally important function.It is further concluded from the experiments that pernicious anæmia in human beings is due to atrophy and inactivity of that part of the stomach which comprises the pyloric-gland region. The experiments may thus be said to have anatomically localized pernicious anæmia in human beings.Experimental pernicious anæmia will presumably be producible by the deliberate removal of the pyloric-gland region.Stomach preparations for the treatment of pernicious anæmia will with advantage be producible from the pyloric-gland region alone.
Therapeutic Observations on Non-Specific Colitis
Authors: Hare Dorothy C. 
Published: July 2019

The clinical characteristics of non-specific colitis and its tendency to spontaneous recovery and relapse make it difficult to assess the results of treatment, but no treatment has been found that acts as a specific cure in an acute attack or which will prevent relapse. The tissues of the colon are highly sensitive to trauma in colitis; treatment by colon lavage therefore often does harm and surgical procedures involving local manipulation are contra-indicated in acute colitis. Antidysenteric serum and Bargen's streptococcal serum and vaccine do not appear to produce a specific curative reaction, and their effect is uncertain. A generous well-balanced diet promotes recovery in convalescence, and long hours of fasting or scanty diet favour relapse. Experimental diets deficient in vitamin B complex produce colitis in monkeys, but in this country diet deficiencies do not appear to be the cause of human colitis, and a complete diet does not protect from relapse. Liver therapy has been found of no value in either acute or chronic colitis, except in a single case with a macrocytic anæmia. Iron in large doses given in chronic colitis with hypochromic anæmia is of striking benefit. Atropine has been used successfully to relieve spasm of the colon causing colic and fæcal constipation.
Vitamin B1 in Human Diets
Authors: Baker Audrey Z. , Wright Margaret D. 
Published: July 2019

Constituents of beri-beri-producing diets, borderline diets, and protective diets given by Braddon and others were analysed for vitamin B1 content by Cowgill. He used a long series of assays published by numerous investigators and calculated the various units and percentage values as milligram equivalents of a yeast powder. He thus obtained approximate vitamin B1 values for these diets. He showed that these values, together with the incidence of beri-beri, justified the application to man of a formula obtained experimentally and gave an indication of man's minimum requirement of the vitamin. In this paper the vitamin B1 value of the same diets has been obtained from direct assays against the International Standard of the constituent foods, raw or cooked, as usually eaten. These are in good agreement with the values drawn from the less direct calculation, and indicate that man's minimum requirement may vary according to weight and food intake between 200 and 500 units daily. The desirable level of B1 intake for adults and children has been studied by analysing in the same way a series of diets recommended by public bodies or by dietitians in England and America. Adults on good diets consume 450 to 750 units daily. High vitamin diets may contain about 1,500 units. Diets recommended for children show relatively higher levels than those for adults, that of a child aged 4 years having nearly 400 units and that of a child aged 11 years having about 650.
Labyrinthine Reactions and Their Relation to the Clinical Tests
Authors: McNally W. J. 
Published: July 2019

The rapid tilt test has shown that the vertical semicircular canals are in close connexion with the whole postural body musculature. Nystagmus reactions are only a small part of semicircular canal sphere of control. Further knowledge of the reaction-pattern of the body musculature resulting from the stimulation of each semicircular canal will help in diagnosing a lesion, not only of the individual semicircular canals, but also—even more important—of its intracranial connexions. The few reaction patterns already known, but not recognized as such, namely post-pointing, falling, and head turning, are true compensatory reactions, more easily understood if so considered and grouped with the protective reactions to the tilt tests. Recognition of the two modes of utricular action is essential to a correct analysis of tilt test reactions. The slow tilt described by Grahe and others, is an excellent test for “first mode” utricular action, but not for “second mode” action or for vertical semicircular canals. The quick tilt is primarily a test of vertical semicircular canal action, but normally the reaction is complicated by reactions from “second mode” utricular stimulation. If this fact is not taken into account the analysis of a reaction to a quick tilt may be misleading. When performing a quick tilt test, in addition to watching for the absence of the protective reaction (due to loss of one or both labyrinths), the investigator should try to note whether there is a tendency for the patient to be more easily thrown in the direction of the tilt—owing to a lesion of the vertical canals, the utricles being intact (“second mode” utricular action)—or whether there is a tendency for the patient to over-compensate (owing to a lesion of the utricles, the vertical canals being intact). If, in addition to the usual equilibrial tests, the quick tilt test is used in this way and a careful analysis is made of the reactions of patients with labyrinthine or intracranial lesions, diagnosis of lesions of individual labyrinthine end-organs or of their intracranial connexions may become a routine procedure in the clinic just as it is now possible in the laboratory.
Some Observations on the Surgical Treatment of Urinary Incontinence
Authors: Millin Terence 
Published: July 2019

Types: A. Essential. B. Paradoxical. C. False. D. True. True incontinence.—A. Congenital: (a) Developmental abnormalities. (b) Malformations of nervous system. B. Acquired: (a) Local abnormalities. (b) False passages. (c) Disturbance of innervation. Anatomy of sphincteric mechanism in male and female. Diagnosis: Need for careful investigation including cysto-urethroscopy, cysto-urethrography, and cysto-manometry. Treatment: A. Physiotherapy. B. Direct surgical repair. C. Surgical diversion of urine. Types of true incontinence amenable to direct surgical repair: A. Epispadias. B. Aberrant ureteric ostia. C. Fistulæ. D. Congenital or acquired defective sphincteric mechanism. Operative treatment of vesico-vaginal fistulæ. Transvesical operation for cure of congenitally defective sphincteric mechanism—report of seven cases. Stress incontinence.—Value of urethrograms to ascertain nature of defect. Operative treatment. Incontinence following prostatic surgery.—Types of operation advocated. New operative procedure utilizing ribbon catgut with demonstrative moving picture.
Autonomic Imbalance and Borderline States of Thyrotoxicosis
Authors: Martin Laurence 
Published: July 2019

Primary thyrotoxicosis may be regarded as having two main components—thyroid overactivity or dysfunction, and instability of the autonomic nervous system. Clinical observation suggests that the proportion of each component varies in individual cases. Results of treatment show that the larger the thyroid element the greater is the benefit of thyroidectomy or X-ray therapy, and the fewer the subsequent residual signs. When nervous instability predominates less relief is obtained by surgery or X-rays, and symptoms may be little changed or even made worse by the addition of hypothyroidism. Cases in which nervous instability predominates, with minimal thyroid dysfunction, have been termed “autonomic imbalance”, “neurocirculatory asthenia”, or “Basedow's disease with no thyrotoxicosis”. Thirteen such cases are described, all of which were females, with average age of 32 years. 9 had enlarged thyroids, 11 complained of palpitations, and 8 of excessive sweating. The basal metabolic rate, estimated in 8 cases, did not exceed +10%. There was some loss of weight in 6 cases, but in none was the appetite increased. The average diurnal pulse-rate did not exceed 95 and sleeping pulse was significantly lower. X-rays of heart, taken in 6 cases, were normal. Psychological troubles in 6 cases. Three cases treated by X-ray therapy and I surgically with no benefit. Remaining 10 cases treated medically with improvement. The group is ill-defined and requires further investigation of cause and treatment. The recognition of autonomic imbalance is important in order to avoid useless thyroidectomy or X-ray therapy, and encourage more extended use of psychotherapy. Investigation of its cause may yield information of value in the ætiological problem of thyrotoxicosis.
Leukopenic Myelosis
Authors: Scott Ronald Bodley 
Published: July 2019

The term “leukopenic myelosis” is used to describe a type of “myeloblastic leukæmia” in which the leukocyte content of the peripheral blood is subnormal for the whole or the greater part of the course of the disease. Separation from the frankly leukæmic cases is made only on the grounds of clinico-hæmatological convenience. Twenty-two cases have been seen in the past four years. The age-incidence varied from 3–73 years; 10 were in males and 12 in females. Acute, subacute, and chronic types may be recognized. In all the main characteristic is a progressive anæmia; in acute cases hæmorrhagic phenomena and necrotic angina are common. The blood-count is characterized by orthochromic or hyperchromic anæmia, sometimes with reticulocytosis and erythroblastosis. Leukopenia may persist throughout the course, or a terminal leukæmia may occur—especially in the chronic cases. The features of the differential count are the presence of myeloblasts—although the percentage may be below 5%—and the hiatus leukæmicus. Thrombocytopenia usually means a rapid course. This clinico-hæmatological picture may be mimicked more or less closely by pernicious anæmia, aplastic anæmia, agranulocytosis, and the leuko-erythroblastic anæmias. The sternal puncture findings are, however, diagnostic, and show a great preponderance of primitive myeloid cells, most frequently with a predomincnce of myeloblasts. In two cases evidence was found that the erythropoietic tissues shared in the hyperplasia.
Surgery in the Treatment of Rheumatoid Arthritis and Ankylosing Spondylitis
Authors: Law W. Alexander 
Published: July 2019

The pain, deformities and disabilities resulting from rheumatoid arthritis and ankylosing spondylitis must be treated by a team composed of physician, physical medicine expert, orthopædic surgeon, and, in certain cases, deep X-ray therapist working simultaneously. The principle of “rest” in order to relieve pain has to be combined with methods designed to preserve and restore function. The multiple joint deformities in these cases may necessitate a long programme of reconstructive or functional treatment, which entails whole-hearted co-operation on the part of the patient in intensive post-operative exercise regime. Procedures advocated for the upper limb include excision of the acromion process together with the subacromial bursa to allow free movement between the central tendon of the deltoid and the tendinous shoulder cuff: arthrodesis of the shoulder in cases where there is more severe joint destruction: in certain cases of elbow-joint arthritis, excision of the radial head and sub-total synovectomy may preserve joint function and avoid or delay the necessity for arthroplasty which can be carried out in two ways: ( a) similar to the formal joint excision, or ( b) re-shaping the lower end of the humerus and upper end of the ulna lining these surfaces with fascia. The former method is preferable in cases of rheumatoid arthritis. To overcome wrist-joint deformity and restore pronation and supination excision of the lower end of the ulna together with radiocarpal fusion in position for optimum function is advocated. Finger and toe joints may be corrected by resection of the bone ends and capsulectomy. In the lower limbs bilateral involvement of the hip-joint is best treated by vitallium mould arthroplasty which may be carried out in four ways: (1) Routine arthroplasty; (2) Modified Whitman procedure; (3) Modified Colonna operation; and (4) The proximal shaft or intertrochanteric arthroplasty. It is essential in these operations to have knowledge of the operative technique, the use of special hip gouges and reamers, and detailed post-operative supervision. For dorsal kyphosis of the spine, spinal osteotomy at the lumbar level provides excellent correction but is an operation demanding care and skill in its execution. The author's remarks are based on experience gained when working with Dr. M. N. Smith-Petersen at the Massachusetts General Hospital, Boston, U.S.A.