bluuebunny/crossref_metadata_2025_split huggingface dataset:
LEFT VENTRICULAR VOLUME IN MAN: THE RELATION TO HEART RATE AND TO END‐DIASTOLIC PRESSURE
Authors: WILCKEN D. E. L. 
Published: September 2017

SummaryResting left ventricular end‐diastolic and end‐systolic volumes were measured by means of a dye‐dilution method in 37 patients, nine with normal cardio‐vascular systems, nine with mitral stenosis, nine with aortic valve disease, and 10 with other conditions. Ventricular volumes were related to heart rate and to the simultaneously measured end‐diastolic pressure. Evidence is presented to indicate that the method is capable of detecting changes in ventricular size, and is not affected by changes in heart rate over the range studied.In the normal subjects there was a significant inverse relationship between heart rate and end‐diastolic volume. There was a direct relationship between the ratio of end‐systolic volume to end‐diastolic volume and heart rate, and an inverse relationship between stroke volume and heart rate. The mean systolic size of the ventricle was smaller at faster heart rates. Such a relationship would tend to minimize increases in myocardial energy expenditure with increases in heart rate.The patients with mitral stenosis had smaller left ventricular volumes than the normal subjects, but the end‐diastolic pressures were also smaller, which finding was consistent with similarity of ventricular distensibility in the two groups. Evidence for an abnormally stiff left ventricle was found in one of the four patients with severe aortic stenosis, in one patient with cardiomyopathy, and in two of the three patients with extreme obesity. The third patient had clinically unsuspected high output left ventricular failure. Evidence for a flabby ventricle was found in two patients with cardiomyopathy and in one patient with predominantly ischæmic heart disease.It seems likely that variations in ventricular stiffness occur during the progression of left ventricular disease and contribute importantly to the production of symptoms, because of effects on left atrial and pulmonary capillary pressures.
URINARY EXCRETION OF TITRATABLE ACID AND ITS RELATIONSHIP TO URINARY pH AND INORGANIC PHOSPHORUS EXCRETION
Authors: GYÖRY A. Z. , NEGRIN A. , EDWARDS K. D. G. 
Published: September 2017

SummaryThe relationship between urinary pH, titratable acid (T.A.) and inorganic phosphorus (I.P.) excretion was examined in a group of 81 hospital out‐patients and some normal volunteers, who presented for one‐day renal function testing. Although the patients had a variety of renal diseases, with glomerular filtration rates ranging from 7 to 146 ml. per minute per 1·73 sq. m., a strictly linear relationship was found between the “ratio of urinary T.A. over urinary I.P.” and urinary pH, expressed by the following equation: urinary T.A./urinary I.P. = 4·2409‐0·5678 × urinary pH. From this relationship it was deduced that abnormalities of urinary T.A. excretion in these patients were mainly dependent on abnormalities of either urinary I.P. excretion, or urinary pH, or both. For any given level of urinary pH, variations in urinary T.A. excretion were caused mainly by variations in urinary I.P. excretion. The theoretically derived sigmoid titration curve of a buffer with a pK′ of 7·20 most closely fitted the experimentally determined regression line, especially between urinary pH values of 6·0 and 8·0 units ; this was consistent with the behaviour of phosphoric acid at 25° C., the temperature of titration. The standard error of the method for deriving urinary I.P. excretion from urinary pH and urinary T.A. excretion measured titrimetrically was 5% ; and this was considered sufficient to allow its use in clinical biochemistry as a screening procedure for urinary I.P. excretion, as part of a one‐day renal function testing system.
LIVER DISEASE IN PREGNANCY, WITH PARTICULAR EMPHASIS ON THE CHOLESTATIC SYNDROMES
Authors: MISTILIS STEVEN P. 
Published: September 2017

SummaryThis review is primarily concerned with the ætiology, pathology, clinical features, differential diagnosis, pathogenesis and treatment of obstetric cholestasis and pruritus of pregnancy. The exact mechanism of the pruritus, jaundice and deranged biochemical state in these disorders is discussed in the light of advances in our understanding of bile salt metabolism and a recent and more acceptable concept of the pathogenesis of cholestasis. The incidence, ætiology and clinical features of cholestasis following oral contraceptives are outlined in detail, and the relationship of these changes to the cholestatic syndrome in the third trimester is discussed. Other hepatic disorders which appear to be related to pregnancy are also briefly reviewed. Biochemical derangements of hepatic function in pregnant women without underlying hepatic disease are considered in detail.
THYMOMA PRESENTING WITH POLYSEROSITIS AND THE LUPUS ERYTHEMATOSUS SYNDROME
Authors: SINGH B. N. 
Published: September 2017

SUMMARYFor systemic lupus erythematosus aud thymoma to occur simultaneously is rare. Such an association in a woman aged 61 years is described. She presented with polyserositis and was found on radiological examination to have progressive enlargement of the mediastinum. An inoperable thymoma of the epithelial‐cell type was demonstrated at thoracotomy and treated with radiotherapy.The diagnosis of systemic lupus erythematosus was established with appropriate serological tests, but no abnormalities of peripheral blood, erythrocyte sedimentation rate or serum proteins were noted during a two‐year period of observation.The possible mechanisms involved in the immunological aspects of thymic disease' are briefly discussed.
THE PHYSIOLOGICAL SIGNIFICANCE OF KINEKARD
Authors: LOWE THOMAS E. 
Published: September 2017

SUMMARYThe name “kinekard” has been given to a fraction that can be prepared from blood plasma by gel‐filtration on polyacrylamide followed by ion‐exchange chromatography on D.E.A.E.‐methacrylate. Kinekard has a powerful inotropic action on cardiac muscle and a pressor action on the arterial circulation. Some evidence is presented that the inotropic and pressor activities of kinekard are independent of each other. In contrast to having a stimulatory action on cardiac and vascular muscle, kinekard is inhibitory to alimentary canal and uterine muscle.Comparison of the properties of kinekard with those of other vasoactive substances shows that the active principle(s) is not a catecholamine, bradykinin, angiotensin, vasopressin or glucagon. No species specificity in source or action of kinekard has been noted.The active principle(s) has not been isolated, but the data suggest that it is a polypeptide with a molecular weight 4,000 to 8,000. It may be, however, that kinekard is a complex of several active principles, some stimulatory and others inhibitory.The plasma concentration of kinekard in man has been determined in a large number of subjects both with respect to inotropic and pressor activity. In healthy people there is only a small variation between individuals, and the concentration is very stable over long periods. In illness marked deviations above and below the normal range occur. Study of the plasma concentration in different regions of the body and in disease states suggests that kinekard originates in the liver either de novo or by an action of the liver on a precursor.It is concluded that kinekard is a complex entity present in the plasma of all species so far examined which appears to be of importance to the body economy.
FAILURE OF POTENT ANTACID THERAPY TO HASTEN HEALING IN CHRONIC GASTRIC ULCERS
Authors: BAUME PETER E. , HUNT JOHN H. 
Published: September 2017

SUMMARYHealing of gastric ulcers in 28 outpatients was measured over a three‐week treatment period. Fifteen patients were treated with an agent (aluminium hydroxide tablets) incapable of elevating the pH of gastric juice, while the other thirteen received large doses of a drug (calcium carbonate) thought to be capable of elevating gastric juice pH.Healing was slightly greater (P=0·12) in patients treated with the ineffective agent but was not impressive in either group. There was no evidence that either treatment exerted a significant effect on gastric ulcer healing, and the results did not support the widely held belief that antacids hasten the healing of gastric ulcers.
BLOOD‐CELL CYCLES IN POLYCYTHÆMIA VERA
Authors: MORLEY ALEC 
Published: September 2017

SUMMARYTwo patients with polycythæmia vera were studied in order to determine whether blood‐cell cycles were present. Neutrophil and platelet cycles were found in one and a reticulocyte cycle in the other. The findings suggest that control of cell production by the marrow is partly retained in polycythæmia vera. In contrast to the findings in chronic granulocytic leukæmia, no evidence was found for slowed cellular maturation.
ON THE PRESENCE OF IMMUNOREACTIVE GROWTH HORMONE IN A BRONCHOGENIC CARCINOMA
Authors: CAMERON D. P. , BURGER H. G. , DEKRETZER D. M. , CATT K. J. , BEST J. B. 
Published: September 2017

SUMMARYRadioimmunoassay and immunohistochemical techniques have been used to demonstrate the presence of immunoreactive human growth hormone (IRHGH) in a bronchogenic carcinoma. While the patient had the clinical manifestations of osteoarthropathy, the role of IRHGH in the pathogenesis of this condition is not established.
GENERALIZED CYTOMEGALOVIRUS INFECTION IN A PATIENT WITH LUPOID HEPATITIS
Authors: ROBSON G. S. , MACKAY I. R. 
Published: September 2017

SUMMARYA woman aged 18 years had an acute “multisystem disease” of which the major impact was on the liver; the LE cell test was positive. The subsequent course of the illness was that of “autoimmune” lupoid hepatitis: serological tests for antinuclear and smooth muscle antibody were positive, and continued treatment with prednisolone was necessary. Splenectomy was required for thrombocytopenia with bruising. Liver biopsy during the illness showed quiescent hepatitis and no virus inclusions in liver cells. After seven years of illness and two years of treatment with azathioprine, a fatal febrile illness occurred with sharp deterioration of liver function. Autopsy revealed inclusions of cytomegalovirus in liver cells and many other tissues.The discussion is concerned with cytomegalovirus as a cause of liver disease in adults, “latent” cytomegalovirus infection, and the degree to which immunosuppressive therapy in this case predisposed to the fatal illness due to cytomegalovirus.
POST‐PARTUM RENAL FAILURE. ? THE GENERALIZED SHWARTZMAN REACTION
Authors: CLARKSON A. R. , MEADOWS R. , LAWRENCE J. R. 
Published: September 2017

SUMMARYThree cases of post‐partum acute renal failure are described, the clinical and pathological features of which are identical to those previously reported. Renal failure accompanied by micro‐angiopathic hremolytic anæmia occurred after a non‐specific prodromal illness early in the puerperium. The features of the disease closely resemble those of thrombotic thrombocytopenic purpura and the hæmolytic uræmic syndrome of children and adults. The similarity of the hæmatological and histological features to their counterparts in the generalized Shwartzman reaction (GSR) is striking. Pregnancy predisposes humans to the GSR, a modification of which may play a part in the pathogenesis of this disease. The prognosis in the cases described and those previously reported is bad because of the irreversible nature of the renal and other pathological changes. Heparin therapy may be of value if given early but clinical recognition of the condition may not occur soon enough.
EPIDEMIOLOGY OF ALCOHOLIC CIRRHOSIS
Authors: WILKINSON PATRICIA , SANTAMARIA JOSEPH N. , RANKIN JAMES G. 
Published: September 2017

SUMMARYSeventy‐seven alcoholic patients, 54 men and 23 women, had cirrhosis of the liver when they first attended the Alcoholism Clinic at St Vincent's Hospital, Melbourne, between July, 1964, and June, 1968. During this period 800 chronic alcoholics, 663 men and 137 women, attended the clinic. Cirrhosis was thus diagnosed twice as often in women as in men.The case histories of the 77 cirrhotic patients were reviewed, and information was collected about socio‐economic status and drinking habits. This information was compared with that obtained from a sample of 220 patients‐‐all those who attended the Alcoholism Clinic between July, 1966, and June, 1967. Most of the cirrhotic patients were beer drinkers, as are the majority of Australian alcoholics. Relatively more cirrhotics were habitual excessive drinkers. The cirrhotic patients did not drink more heavily, but they had drunk excessively for longer when their cirrhosis was diagnosed. Cirrhotic women, however, had drunk excessively for a significantly shorter time than cirrhotic men.No difference was found in the incidence of either social isolation or clinical peripheral neuropathy between cirrhotic and alcoholic patients, or between male and female cirrhotics. Cirrhosis was not commoner among the lower socio‐economic groups. These findings were interpreted as suggesting that nutrition did not play an important part in the causation of the liver disease.Women appear to be more susceptible than men to cirrhosis of the alcoholic, and unremitting habitual excess more damaging than intermittent alcohol abuse. Some undetermined predisposition must also exist, since the disease is still sporadic even when these factors operate.
THE EFFECT OF GIARDIA LAMBLIA INFESTATION ON THE GASTRO‐INTESTINAL TRACT
Authors: ALP M. H. , HISLOP I. G. 
Published: September 2017

SUMMARYFive patients with Giardia Iamblia infestation are presented, all of whom showed evidence of malabsorption. Marked mucosal damage, found in two cases, was reversible within four weeks of commencement of mepacrine therapy. One patient, who failed to respond to this therapy, was treated successfully with a course of metronidazole. The pathogenesis of malabsorption in Giardia Iamblia infestation is discussed. It is suggested that the malabsorption results from mucosal damage consequent on a “toxic effect” exerted by the organism.Giardia Iamblia infestation is common in Australia. A careful search for the parasite is recommended in patients who have experienced abdominal pain and diarrhœa, particularly where there is evidence of malabsorption.
GASTRO‐INTESTINAL BLEEDING: THE ROLE OF VITAMIN C
Authors: HANSKY J. , ALLMAND FIONA 
Published: September 2017

SUMMARYDuring a three‐year period, 93 patients selected at random, who were admitted to hospital with either hæmatemesis or melrena, had a detailed dietary history taken; these dietary factors were compared with a group of hospital patients (matched by age and sex) with non‐gastro‐intestinal diseases. The 93 patients with gastro‐duodenal bleeding were further subdivided on the basis of radiological studies, using barium, endoscopy or laparotomy into 37 patients with duodenal ulcer, 12 patients with gastric ulcer, nine patients with hiatus hernia, four patients with gastric carcinoma, and 31 patients in whom the site or source of bleeding remained undetermined.Thirty‐four of the 93 patients with gastro‐duodenal bleeding had a vitamin C intake of under 50 mg per day, whereas only 14 of the control group had a similarly low intake. In the group of those with bleeding, a history of excessive intake of analgesics was obtained in 17 patients, only three of whom had a low vitamin C intake.This preliminary study indicates that vitamin C deficiency may be an important factor in the genesis of gastro‐intestinal hremorrhage, particularly in the group in which no cause for the bleeding is found.
Effects of Intravenous Alcohol on Motility of the Duodenum and of the Sphincter of Oddi
Authors: Pirola R. C. , Davis A. E. 
Published: September 2017

SummaryNormal subjects were given a constant infusion of secretin and consecutive 5‐minute samples of duodenal aspirate were collected. Tests in which bile was present in duodenal aspirate were discarded. In 8 subjects, intravenous alcohol caused a significant reduction in volume without a fall in bicarbonate concentrations. In 3 subjects, intravenous dextrose did not cause a fall in volumes of aspirate. These findings indicate that intravenous alcohol causes obstruction to pancreatic outflow, presumably as a result of contraction of the sphincter of Oddi.In view of the functional and anatomical connections between the duodenal and sphincteric musculature, the effects of intravenous alcohol on duodenal motility were studied by combined electromanometric and cineradiologic techniques. Intravenous alcohol in eleven normal subjects caused a significant increase in duodenal motility, whereas intravenous dextrose had no effect.It is postulated that alcohol has a systemic effect leading to obstruction to pancreatic outflow and that this is one factor in the production of alcoholic pancreatitis.
Anaemia and Temporary Erythroblastopaenia in Children
Authors: Lovric V. A. 
Published: September 2017

SummaryOver a period of 7 years, 12 patients were seen at the Royal Alexandra Hospital for Children with a symptomatic normocytic, normochromic anaemia and reticulocytopaenia. The initial bone marrow aspirates revealed erythroblastopaenia as the only abnormality.The cause of this condition remains uncertain. However, all children fully recovered within a few weeks after diagnosis. A single course of steroid therapy was given to 3 children, whilst the remainder received no therapy. Recurrence was observed in one child only. Thus, on clinical and haematological grounds, differentiation from Gasser's series could be made.Failure to recognize this syndrome will lead to a number of unnecessary investigations. Furthermore, a life‐long iatrogenic diagnostic label may be given in error for a benign, self‐limiting condition in childhood.
Lactose Intolerance in Australian‐born Chinese
Authors: Bolin T. D. , Davis A. E. 
Published: September 2017

SummaryControversy exists over the aetiology of primary lactase deficiency, which may be either a genetic defect or an adaptive phenomenon. The incidence of lactose intolerance in a group of Australian‐born Chinese was 56% compared to an incidence of 95–100% in Chinese resident in Australia and indigenous Chinese in Singapore. The lower incidence of intolerance in Australian‐born Chinese suggested that an environmental rather than a genetic factor was operative and this appeared to be a high intake of lactose in the tolerant subjects.
Hypertension and Severe Hyperkalaemia Associated with Suppression of Renin and Aldosterone and Completely Reversed by Dietary Sodium Restriction
Authors: Gordon Richard D. , Geddesj Robin A. , Pawseynl Charles G. K. , O'Halloran Michael W. 
Published: September 2017

SummaryA 10‐year‐old girl presenting with short stature had hypertension, severe hyperkalaemia (8.5 mEq/litre), mild acidaemia (arterial pH, 7.30) and periodic paralysis. It was postulated that the basic defect was a renal tubular avidity for sodium at a site proximal to the action of aldosterone, resulting in expansion of blood volume which in turn caused suppression of renin and of aldosterone and “escape” from relentless sodium retention. Plasma volume was increased, plasma renin activity undetectable, the urinary excretion of aldosterone very low and the renal tubule responsive to endogenous and exogenous aldosterone. The hypothesis was tested by appropriate balance studies including demonstration of renal tubular avidity for sodium despite low levels of aldosterone. Correction of all abnormalities followed prolonged dietary sodium restriction which brought about elevation of renin and aldosterone to normal levels. Correction of the hyperkalaemia or of the acidaemia while maintaining strict sodium balance did not correct the other abnormalities. Arterial pressor hypersensitivity to the stimulus of cold and to infused angiotensin and norepinephrine was reduced to normal when dietary sodium was restricted, associated with a return of blood pressure to normal levels. Following institution of dietary sodium restriction, attacks of muscle paralysis ceased and growth rate increased. The components of this syndrome are opposite to those found accompanying another rare congenital renal lesion associated with severely disturbed renin‐aldosterone physiology, and usually referred to as “Bartter's Syndrome”.
Cushing's Syndrome — A Review of the Response to Treatment in 42 Patients
Authors: Taft Pincus , Martin F. I. R. , Melick Roger 
Published: September 2017

SummaryThe course after treatment of 42 patients suffering from Cushing's syndrome is reviewed, the follow‐up period being from twelve months to twelve years. In 30 instances the syndrome was due to bilateral adrenal hyperplasia, in five to adrenal carcinoma, in four to unilateral adenoma, and in three to non‐endocrine carcinoma. Treatment was mainly by adrenal resection—total in the hyperplasia group, unilateral for the adenoma patients.During the follow‐up period 16 patients (38%) have died. These include all eight with carcinoma and eight of the 30 suffering from adrenal hyperplasia.Whilst most of the 26 survivors can be regarded subjectively as being in good health, only ten patients have no clinical abnormality. Hypertension has persisted in nine patients and diabetes in two. Eleven patients have presumed pituitary dysfunction: six of these have pituitary tumours, while a further five have pigmentation only at present. Growth has been interrupted in the two children treated. The psychiatric changes, where present, improved slowly after treatment and three deaths in the hyperplasia group were due to suicide within six months of treatment.
Polyarteritis Nodosa: The Natural History of a Spontaneously Occurring Model in Outbred Mice
Authors: Wigley R. D. , Couchman K. G. , Maulel Rachel 
Published: September 2017

SummarySpontaneous arteritis resembling the chronic form of the human disease polyartiritis nodosa occurred in up to 60% of outbred PN mice. The lesions were similar in histology and distribution to peri‐arteritis nodosa as described by Kussmaul and Maier, the marked round cell infiltration occurring in 80% of mice at 18 months being the main difference from the human disease. Perivascular cuffing of renal vessels invariably preceded the arteritis, the frequency of which did not appear to be influenced by lymphoma, chronic virus pneumonia or amyloidosis. There was a significant association with antinuclear antibodies and a low incidence of red cell antibody, but no evidence of haemolytic anaemia. The possibility that this disease is due to a chronic virus infection is discussed.
Involvement of Bulbar Muscles in Thyrotoxic Myopathy
Authors: Joasoo Aet , Murray I. P. C. , Steinbeck A. W. 
Published: September 2017

SummaryTwelve cases of thyrotoxic myopathy, with involvement of bulbar muscles, are reported. It appears likely that this manifestation of thyrotoxicosis is not as uncommon as has previously been suggested.
The Spectrum of Protein Calorie Malnutrition in Adolescents
Authors: Caughey J. E. 
Published: September 2017

SummaryThe natural history of adolescent malnutrition has been studied in boys at school and in hospital in Iran. A spectrum of malnutrition has been demonstrated, ranging from simple growth retardation to severe malnutrition with sexual infantilism, iron‐deficiency anaemia, hepatosplenomegaly, generalised oedema and low serum albumin and zinc levels. Primary malnutrition (simple starvation), together with secondary malnutrition (starvation complicated by infections, geophagia and helminthiasis), is significant aetiologically. It is proposed on the basis of clinical and biochemical studies and the response to high‐protein intake that protein deficiency is the major factor in adolescent malnutrition in Iran.