bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE CASUAL ARTERIAL PRESSURE OF FIJIANS AND INDIANS IN FIJI
Authors: LOVELL R. R. H. , MADDOCKS I. , ROGERSON G. W. 
Published: September 2017

SummaryCasual arterial blood pressure has been measured in population samples of Fijians and Indians inhabiting Fiji.Certain features of blood pressure found in peoples of Europe and America have been found in both races. The means and standard deviations of systolic pressures rise with age. The means of diastolic pressures rise, at least to the sixth decade. Pressures rise more in females than in males. Frequency distributions of pressures are continuous and mostly show positive skewness. Each race contains subjects with markedly raised pressures.The overall mean systolic and diastolic pressures of Fijians and Indians are similar, but pressures rise more with age in Indians than in Fijians. Differences between races in the younger groups are reduced when differences in arm circumference are taken into account. Correction for arm circumference increases the relatively higher pressures of elderly Indians.The levels of blood pressure of Fijians and Indians are compared in detail with those reported in a London population. The pressures of Fijians, Indians and Londoners are similar up to the sixth decade. Thereafter, those of Fijians and Indians fall below those of Londoners.This similarity of pressures up to the sixth decade in such contrasted races is emphasized, for ways in which the races differ have previously been held to account for differences in pressures between other races. The reasons for the differences in later years are discussed.
MORPHOGENESIS OF UNILATERAL MULTICYSTIC KIDNEY IN CHILDHOOD
Authors: BIALESTOCK DORA 
Published: September 2017

SummaryThe clinical details of a child R.W., aged 13 months, in whom an abnormal cystic kidney was excised, are recorded.The microdissection study of this kidney revealed that some of the nephrons were quantitatively comparable with those of a normal kidney from a child of the same age.Failure of union at the site of junction of distal convoluted tubules and collecting tubules of the nephrons was demonstrated in about one‐third of the nephrons studied. These observations support the embryologists who consider that the excretory and collecting systems are formed separately and unite at this junction.All the abnormalities observed could not be explained by this simple mechanical explanation. The adverse stimuli responsible for the cystic changes in this kidney were probably active after the renal system had already normally differentiated. This would indicate that the morphogenesis of this condition, unilateral cystic disease in infancy, should be regarded as different from that of polycystic disease. Clinically, such a differentiation has been suggested by all the other reports of unilateral multicystic kidney.
SERUM LIPOPROTEINS AND BLOOD COAGULATION IN HEALTHY AND ATHEROSCLEROTIC MEN
Authors: GOLDRICK R. B. 
Published: September 2017

SummarySerial estimations of serum lipids and blood clotting were made under basal conditions in nine healthy young men and in 10 atherosclerotic older men.When the serum concentrations of beta lipoprotein lipids were reduced by substituting unsaturated fats in the diet, there was a significant lengthening of the whole blood clotting time (W.B.C.T.) in the atherosclerotic subjects. No such change occurred in the healthy controls, and the “Stypven” time was unaltered in both groups of subjects.The “Stypven” time was consistently longer in the healthy men, but there was no difference in the W.B.C.T. between subjects until clotting in the atherosclerotic subjects became longer with the fall in serum lipid levels.Certain differences in the lipoprotein transport of cholesterol were noted. In the healthy subjects a rise in total cholesterol level was borne by both alpha and beta lipoproteins, although the beta fraction was mainly responsible for the rise in total cholesterol level. On the other hand, in the atherosclerotic subjects a rise in total cholesterol level was associated with a fall in alpha and a rise in beta lipoprotein. The significance of these differences in regard to atherogenesis is discussed.Among the healthy subjects alpha lipoprotein was associated with longer clotting times in the “Stypven” test and shorter W.B.C.T. On the other hand, in the atherosclerotic men both measures of clotting varied together. As the concentration of alpha lipoprotein increased, clotting times became longer, and as the beta lipoprotein concentration rose, clotting was accelerated. These associations suggest that the serum lipoproteins or some closely associated factors influence the rate of blood coagulation.
PRECIPITIN TESTS FOR AUTO‐IMMUNIZING THYROIDITIS
Authors: WATSON D. 
Published: September 2017

SummaryThe results of precipitin and flocculation tests on the serum of 76 patients with thyroid disease are presented and discussed. A positive precipitin reaction to thyroid extract indicates that, at one time or other, the patient has become sensitized to thyroglobulin.A thyroid precipitin test employing normal electrophoretic equipment is described. The test is slightly more sensitive, simpler and more rapid than the agar diffusion test. Taken in conjunction with clinical assessment and other available investigations, this precipitin test is a valuable diagnostic procedure.
HEREDITY IN PRIMARY GOUT
Authors: EMMERSON B. T. 
Published: September 2017

SummaryTwo family pedigrees are presented which contain persons homozygous for the gouty trait. In the first family, asymptomatic hyperuricMmia occurred in both parents of a patient with gout of extreme severity and rapid progression. The only relative with clinical gout was a cousin of the patient's mother. In the second family, gout or hyperuricæmia could be traced through five generations. From the union of one of the gouty males of this family and a hyperuricæmic female four hyperuriæmic and gouty children resulted. Three of these children are also hypertensive, and two have evidence of renal impairment. The patient in the index case in the first family had renal disease due to gout itself, while the second family demonstrates that renal disease in gouty subjects may also be due to the association in one family of hyperuricMmia and primary hypertensive vascular disease. Homozygosity for the gouty trait is suggested as a possible cause of gout occurring with undue severity or with an unusually wide family incidence.
CHANGES IN URINARY STEROID EXCRETION DURING EXAMINATIONS
Authors: MELICK ROGER 
Published: September 2017

SummaryUrinary total 17‐hydroxycorticosteroid (17‐OHCS) excretion and 17‐ketosteroid (17‐KS) excretion by 10 university students during day and night periods were measured four weeks before and during university annual examinations. A significant increase in the excretion of total 17‐OHCS occurred during examinations in both day and night periods. No rise occurred in 17‐KS excretion. The normal diurnal variation of excretion was present both before and during examinations for both total 17‐OHCS and 17‐KS. It is concluded that examinations caused an increase in basal total 17‐OHCS excretion as well as an increase during the examinations themselves, and that the adrenal‐stimulating factor was not enough to cause a rise in 17‐KS excretion detectable by the method used.
ACUTE DIFFUSE INTERSTITIAL PULMONARY FIBROSIS IN SCLERODERMA
Authors: READ JOHN , COLEBATCH H. J. H. , SMITH K. VINER 
Published: September 2017

SummaryA case of generalized scleroderma with pulmonary manifestations is described.Completely normal findings on detailed studies of respiratory function three and a half months before the patient's death allow the pulmonary lesions to be described as acute diffuse interstitial pulmonary fibrosis.The histological appearances in the lungs are believed to represent the earliest manifestations of "scleroderma lung" yet described.
BONE CHANGES ASSOCIATED WITH CORTISONE ADMINISTRATION IN THE RAT : CONVERSION OF ‘RICKETS’ TO ‘OSTEOPOROSIS’
Authors: STOREY E. 
Published: September 2017

SummaryMany studies of bone disorders showing density variation have been of a general metabolic type—intake, output and serum levels of calcium and other ions. These play an important part in the development of our knowledge, but, necessarily, give only an indication of average osseous change ; this is different in different bones. Morphological studies of several individual bones in any given case are thus an essential counterpart of the other form of inquiry.Furthermore, it seems from the recent literature that osteoporosis and osteomalacia are coming be regarded clinically, more and more, as disease conditions or possibly syndromes, whereas they should not represent more than processes. To elucidate some aspects of these questions, experimental investgations have been undertaken.Cortisone administration to rats with fully developed low‐calcium/high‐phosphorus "rickets", characterized by widened osteoid seams and areas of bone resorption, results in disappearance of osteoid seams, diminution in size and number of bone trabeculæ and development of osteoporosis. Detailed studies of this change in bone structure show that in this form of rickets resorption is confined to calcified bone ; osteoid, lined by mast cells, does not resorb except where areas of sporadic calcification appear in it. With cortisone, osteoid material continues to calcify ; but new osteoid formation no longer appears, mast cells slowly disappear, and the area of calcified bone surface undergoing resorption increases in extent. Thus the anti‐anabolic effect of cortisone, by inhibiting further matrix formation, is indirectly responsible for increased resorption. These results suggest that "rickets" and osteoporosis are interconvertible, and that the type of bone change, in the presence of abnormal calcium metabolism of any kind, may depend on the level of cortisone (or comparable hormones).
MAXIMAL EXPIRATORY FLOW RATES IN AUSTRALIAN ADULTS
Authors: SELBY T. , READ JOHN 
Published: September 2017

SummaryThe Wright peak flow meter is a useful, simple, portable instrument for the recording of maximal expiratory flow rates (M.E.F.), which reflect the degree of obstruction to air flow.Normal values for M.E.F. under Australian conditions have been determined in 44 males and 76 females, aged 18 to 78 years, who had no history of chronic respiratory disease and who had never smoked. Regression equations have been prepared for the prediction of “normal values” in practice. In normal subjects, the recorded M.E.F. may vary from the predicted value by up to 20%. In 10% of the subjects, the reproducibility of the test was not good.Increasing age is associated with loss of M.E.F. in both sexes (for males 2·1 litres per minute, and for females 1·2 litres per minute, each year). In males, stature (as reflected by height) is important as a determinant of the absolute value for M.E.F.In women over the age of 60 years, three determinations are adequate to achieve a maximum value, but in younger women at least four determinations and in men at least five determinations should be made.
DISSEMINATED TUBERCULOSIS AND BONE MARROW DYSCRASIAS
Authors: DAWBORN J. K. , COWLING D. C. 
Published: September 2017

SummaryThe clinical features and autopsy findings are described in two cases of pancytopenia, four cases of leukæmia and one case of myelofibrosis, all of which were associated with disseminated tuberculosis.It is considered that tuberculosis preceded and may have caused pancytopenia in three cases. Diagnosis in such cases is aided by biopsy of lymph glands, liver and bone marrow from the iliac crest, and by culture of biopsy material. The pancytopenia should respond to anti‐tuberculous chemotherapy, but in one case it progressed to leukæmia despite treatment.Tuberculosis appeared as a complication in three cases of leukæmia and in one case of myelofibrosis. These cases pursue their natural course despite anti‐tuberculous chemotherapy. Tuberculosis seems more likely to occur in patients receiving cortisone.We consider that “ leukæmoid reaction ” to tuberculosis is not common, and that, more commonly, leukæmia is complicated by tuberculosis. In a few cases tuberculosis may be an ætiological factor in the blood dyscrasia, most commonly in cases of pancytopenia.
EARLY ENDOSCOPY AND RADIOLOGY IN THE MANAGEMENT OF HÆMATEMESIS AND MELÆNA
Authors: COOKE A. R. , SKYRING A. P. , STEPHEN D. D. 
Published: September 2017

SummaryA series of 52 unselected patients with upper gastro‐intestinal tract bleeding was studied by means of a combination of endoscopy in the ward and radiology within 36 hours of admission to hospital. The early diagnosis was confirmed at autopsy, at operation or at a routine barium‐meal X‐ray examination before the patient's discharge from hospital. A positive diagnosis was made in over 80% of cases, and in no instance was a false diagnosis made. All gastric ulcers were detected by this method, but duodenal ulcers were missed on two occasions. Acute gastric erosions were seen in it patients. There remained a group of seven cases in which no diagnosis was made by either early or late investigation.A vigorous approach to this problem is completely safe to the patient, and places further management, especially if surgery is contemplated, on a safer and surer clinical basis.
CEREBRAL ANEURYSMS AND CONGENITAL ABNORMALITIES
Authors: STEHBENS W. E. 
Published: September 2017

SummaryThe prevalence of congenital abnormalities in a series of 215 subjects with cerebral aneurysms proven at autopsy was not significantly greater than that in a control series of 849 subjects or in a series of 351 with non‐aneurysmal cerebral hæmorrhage. Apart from coarctation of the aorta and polycystic kidneys, the incidence was not higher than in the general population.It is concluded that there is insufficient evidence to support the postulate that the association of cerebral aneurysms and developmental errors is significant. However, cerebral aneurysms frequently occur with polycystic disease of the kidneys and coarctation of the aorta, and these are the only two congenital diseases commonly associated with systemic hypertension. The coexistence of the lesions could be due to the concomitant hypertension and arterial degenerative disease rather than to hypothetical congenital factors.
THE ELDERLY HÆMOPHILIAC
Authors: KERR C. B. 
Published: September 2017

SummaryThere is evidence that more hemophiliacs are entering the older age groups. Among 20 patients aged over 40 years, two distinct patterns of disease were encountered, each depending on the severity of the hæmophilia. Severely and moderately severely affected patients were disabled from the effects of repeated hæmorrhage into joints and tissues of limbs. The dramatic bleeding of young hemophiliacs was seldom seen. Mildly affected patients were highly selected, owing to trauma or local abnormality revealing their relatively occult hæmorrhagic tendency. Gastro‐duodenal bleeding was the most frequent clinical manifestation. The implications of surgery in older hæmophiliacs are discussed. Although the therapeutic approach remains conservative, evidence is given that elective surgery may be safely offered to selected patients with otherwise irremediable crippling or dangerous disease. Socio‐economic and psychological adjustment of most patients appeared satisfactory, but several showed sufficient features of psychological or social disturbance to warrant emphasizing the importance of a sound developmental and vocational training programme in the early years of life.
THE ASSOCIATION OF RENAL TUBULAR ACIDOSIS WITH HYPERGLOBULINÆMIC PURPURA
Authors: COHEN ALEX , WAY B. J. 
Published: September 2017

SummaryA case of purpura hyperglobulinænica is described in which the classical features of renal tubular acidosis were also present, and a second case of purpura hyperglobulinæmica is presented with features suggesting the early phase of renal tubular acidosis.Attention is drawn to the possible combination of these conditions in one other case reported in the literature, and their possible ætiological relationship is discussed.
PROTEIN‐LOSING ENTEROPATHY
Authors: ESPINER E. A. , BEAVEN D. W. 
Published: September 2017

SummaryA man, aged 54 years, presented with œdema, ascites and hypoproteinæmia of 20 years' duration. Results of investigation of cardiac, renal and hepatic function were normal. There was no history suggesting a gastro‐intestinal disorder and investigation of bowel function was largely unproductive. Studies with I131 albumin and polyvinyl pyrrolidone established that protein was being lost through the bowel. The I131 albumin disappearance studies were repeated under steroid cover, but no change in disappearance rates was observed. Laparotomy showed an œdematous and hyperæmic small bowel with dilatation of serosal lymphatics, while jejunal biopsy material disclosed widespread lymphangiectasia—the most striking lesion of this protein‐losing enteropathy.
THE NORMAL RANGE OF PLASMA URATE LEVELS
Authors: EMMERSON B. T. , SANDILANDS PAMELA 
Published: September 2017

SUMMARYThe plasma levels of urate were determined in a group of apparently healthy young subjects, 100 being males and 100 females, none of whom had a family history of gout or evidence of renal disease. The results in the males appeared to have a bimodal distribution, suggesting that they might represent two populations, one normal and the other hyperuricæmic. Although there was no sharp dividing line, the plasma urate levels for these two groups seemed to separate at a value of about 7·0 mg. per 100 ml. The results in females approximated more to a normal distribution, and only one result exceeded 5·7 mg. per 100 ml. If, on the other hand, the value which excluded the upper 5% of results was calculated from the mean and standard deviation (the requirement being disregarded that the distribution should be a normal one for this to apply), results almost identical with those already chosen would be obtained.These findings have therefore suggested that values of 7·0 mg. per 100 ml. for males and 5·7 mg. per 100 ml. for females be taken as the upper limits for the normal plasma urate level estimated by the colorimetric method. A uricase method of estimation produced results which were about 0.2 mg. per 100 ml. lower than those produced by this colorimetric method. As the distribution of the results for males could also be interpreted as being a normal curve skewed towards the higher values, it is considered that much larger numbers than these would be needed to allow any conclusions to be drawn concerning the theories of inheritance of the plasma urate level.
DIAGNOSIS AND TREATMENT OF STROKES: ANATOMICAL AND PATHOLOGICAL ASPECTS
Authors: ANDERSON R. McD. 
Published: September 2017

SUMMARYThis report deals with the major findings in an autopsy series of 351 cases of cerebrovascular accident. In addition, anatomical studies are presented which help to clarify some of the pathological findings. In the cases of cerebral infarction, a high incidence of associated heart disease was found. In the hæmorrhage group, the importance of ruptured saccular aneurysm is emphasized.
ROCKY CREEK, AN OUTLYING FOCUS OF SCRUB TYPHUS IN NORTH QUEENSLAND
Authors: BARROW G. J. , DOMROW R. , DERRICK E. H. 
Published: September 2017

SUMMARYEight cases of scrub typhus have arisen at Rocky Creek, near Atherton, North Queensland, in a focus detached from the main scrub‐typhus region. In this comparatively dry zone, three large springs have created oases with rain forest and a highly humid microclimate. Six larval Leptotrombidium deliense were found in the ears of four of 48 small animals captured in the vicinity of the springs. The presence of these mites, although scanty, indicates that these oases still carry a potential scrub‐typhus risk, and illustrates the tendency of a focus to persist for many years. Rocky Creek, with an average annual temperature of about 69° F., is the coolest scrub‐typhus focus so far studied in Queensland.
THE USE OF THE I131 HIPPURAN RENOCYSTOGRAM IN THE DIAGNOSIS OF RENAL DISEASE
Authors: DODGE E. A. 
Published: September 2017

SummaryFifty normal subjects and 250 patients with renal disease were studied by the use of I131 sodium ortho‐iodohippurate and the external scintillation counting technique. The renographic appearances in a number of renal diseases are described, and their significance and interpretation are discussed. Special reference is made to the use of the dehydration renogram in the diagnosis of renal artery stenosis. Measurement of the bladder and urine radioactivity at the conclusion of the procedure was of value in the assessment of residual urine and the estimation of total renal function. As part of this test, a method for determining the occurrence of vesico‐ureteric reflux is described.I131 hippuran renocystography proved to be an easily performed, well tolerated, reproducible, reliable and economic screening test of unilateral and bilateral renal function. It was of value in the diagnosis of renal disease when the intravenous pyelogram alone was inconclusive or contraindicated because of uræmia, iodine sensitivity and gross ascites, and in the very ill patient. Because the radiation dosage is minute, it may be used in following the progress of renal disease, especially in childhood.
THYMIC ABNORMALITY IN SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: MACKAY IAN R. , MASEL M. , BURNET F. M. 
Published: September 2017

SummaryA young female patient with fulminant systemic lupus erythematosus, mainly affecting the brain and kidneys, required treatment with very high doses of prednisolone, up to 400 mg. per day. This led to moderate improvement in renal function, but without corresponding histological improvement. A fatal cerebral hæmorrhage occurred after ten weeks of treatment.Necropsy revealed diffuse and focal epithelial hyperplasia and “atypical germinal centres” in the medulla of the thymus, resembling thymic abnormalities observed in lupus erythematosus by McGehee Harvey. These abnormalities were interpreted on the basis of Clark's concept of localized thymic units or “packets of cells” delimited by epithelium ; special importance was given to processes concerned with lymphocyte proliferation within these units and the passage of lymphocytes through the epithelial and endothelial barrier into the blood‐stream.We suggest that cells entering, or arising in, these thymic units undergo primary immunological differentiation : any cells reactive with self‐components are suppressed by a substance which inhibits the development of immunological competence. The emergence of cell‐lines intrinsically resistant to control results in immunological reactions being initiated within the thymus, so causing proliferative activity of labile epithelial and endothelial cells. This, with the modifying effects of corticosteroid therapy, could produce the appearances seen in the present case.