bluuebunny/crossref_metadata_2025_split huggingface dataset:
OLIGURIC RENAL FAILURE: A REPORT OF 400 CASES INCLUDING CLASSIFICATION, SURVIVAL AND RESPONSE TO DIALYSIS
Authors: KIRKLAND K. , EDWARDS K. D. G. , WHYTE H. M. 
Published: September 2017

SUMMARYA brief review is given of the clinical experience of the Renal Unit in 400 consecutive patient admissions for oliguric renal failure over a period of six and a half years. Clinical classification into 13 groups, depending on the circumstances initiating acute renal failure, revealed marked variation in survival (10% to 85%), and the need for and the results of dialysis also varied between groups. The findings support an earlier analysis of 275 cases (Healy et alii, 1963).Ranked in ascending order of survival, the circumstances in which oliguria occurred were: primary renal disease; cardio‐vascular disease; other generalized medical disease; septicæmia; severe burns and trauma (53% of patients, with 10% to 30% survival) ; intra‐abdominal disorders, both medical and surgical (20% of patients, with 50% survival) ; urological procedures and reactions to drugs and chemicals (14% of patients, with 60% survival); and obstetrical cases and blood transfusion reactions (13% of patients, with 85% survival). Classification into such groups, which can be simply made, is valuable in assessing prognosis and the results of treatment.Hæmodialysis and peritoneal dialysis were reserved until severe urmia developed in spite of conservative therapy (60% of cases). Survival was thought to depend on dialysis in 30% of all cases. Frequent or prophylactic dialysis (Easterling and Forland, 1964), when compared with the present series, did not seem to offer significantly better survival rates.
A METABOLIC DEFECT OF THE LYMPHOCYTES IN A CASE OF HYPOGAMMAGLOBULINÆMIA
Authors: FORBES I. J. , MILAZZO S. C. 
Published: September 2017

SUMMARYA case of adult primary (acquired) hypogammaglobulinæmia is described. Mucosal atrophy of the stomach with lymphocytic infiltration was an unusual finding.By immunoelectrophoretic analysis, gamma‐2 globulin was demonstrated in the serum, but beta‐2A and beta‐2M globulins were not detected. It is probable that most of the gamma‐2 globulin came from therapeutically administered globulin. The level of gamma globulin was estimated to be 20 mg. per 100 ml. before treatment with pooled gamma globulin was instituted.Lymphocyte function studies showed that the patient's lymphocytes were capable of synthesizing protein in normal amounts under basal conditions. However, they failed to show the marked increase in globulin synthesis that normal lymphocytes show in the presence of phytohæmagglutinin (PHA), although there was no impairment of the cells' ability to undergo transformation when stimulated with this substance.A metabolic defect is therefore demonstrated: the circulating lymphoid cells have lost the capacity to synthesize additional globulin when transforming in the presence of PHA.
ALVEOLAR HYDATID DISEASE: A CASE REPORT
Authors: BETT J. H. N. , ESSEX W. B. 
Published: September 2017

SUMMARYA case of alveolar hydatid disease in a Russian migrant is described. The alveolar form of hydatid disease is characterized by an infiltrative mode of growth associated with extensive necrosis and caseation. A definite outer limiting membrane as found in the ordinary form of the disease is absent.
THE VALUE OF PROTEIN‐BOUND IODINE AND TRIIODOTHYRONINE RESIN UPTAKE IN ASSESSING THYROID FUNCTION
Authors: WELLBY MAURICE , O'HALLORAN M. W. 
Published: September 2017

SUMMARYThe experiences gained in performing protein‐bound iodine (P.B.I.) and triiodothyronine resin uptake (T3 uptake) assays in a series of 332 plasma samples from human subjects are described. The subjects are classified into clinical categories on the basis of their thyroid status, and from a consideration of extrathyroid factors such as iodine contamination and the presence of thyroid‐binding abnormalities in the serum. There are categories also for patients undergoing treatment for thyroid disorders.The P.B.I. assay was performed by Acland's (1957) procedure, and the T3 uptake assay by modifications of the method of Woldring et alii (1961). The results in each category are subjected to an analysis of variance.For euthyroid subjects without goitre, the mean value for P.B.I. level is 5·65 µg. per 100 ml. of plasma, with a standard deviation of 0·72. The value for T3 uptake is 91·4%, with a standard deviation of 10·7. The values for euthyroid subjects with goitre are not significantly different from those without. Iodine contamination causes no change in the T3 uptake value. In subjects with increased binding, the P.B.I. level is elevated and the T3 uptake is depressed. With decreased binding, the P.B.I. level is depressed and the T3 uptake is increased.The “P.B.I.×T3 uptake index” of Clark and Horn (1965) is found to be very useful in assessing the thyroid status of patients with binding abnormalities. The P.B.I. assay is found to be the method of choice in the diagnosis of primary thyrotoxicosis and myxœdema. The P.B.I. assay is misleading, but the T3 uptake is accurate in the diagnosis of the thyroid status of thyroxine‐treated myxœdema patients. The P.B.I.×T3 uptake index is more useful than either the P.B.I. assay or the T3 uptake alone in assessing the response to radioiodine therapy of thyrotoxic patients.
THROMBO‐EMBOLISM AND INCREASED PLATELET ADHESIVENESS IN POST‐SPLENECTOMY THROMBOCYTOSIS
Authors: HIRSH J. , MCBRIDE J. A. , DACIE J. V. 
Published: September 2017

SUMMARYPlatelet count data have been obtained from patients suffering from various types of hereditary hæmolytic anæmia, sideroblastic anæmia and thalassæmia, and from hæmatologically normal controls. One‐third of the patients studied had been subjected to splenectomy. Patients with persistent anæmia after splenectomy developed post‐splenectomy thrombocytosis. The percentage of platelets which were adhesive was increased after splenectomy irrespective of whether anæmia and thrombocytosis persisted.Six of the 25 patients with persistent post‐splenectomy thrombocytosis developed thrombo‐embolic complications. On the other hand, signs or symptoms of thrombo‐embolism were not observed in any of 21 patients who had normal platelet counts after splenectomy, or in 72 patients suffering from similar disorders who had not been subjected to splenectomy. The cause of the high incidence of thrombo‐embolic complications in patients with continuing anæmia after splenectomy is not completely understood, but it seems likely that thrombocytosis and increased platelet adhesiveness may play a part.
ŒSOPHAGEAL MOTILITY STUDIES
Authors: HANSKY J. 
Published: September 2017

SUMMARYA study has been made of the propulsive and pressure characteristics of the œsophagus and its sphincters in eight normal subjects and in 65 patients with œsophageal symptoms, by means of water‐filled, open‐ended tubes connected to external strain gauge transducers.The patterns of ordered and disordered œsophageal motility have generally conformed to those found by others. The results suggest that this method of investigation permits a precise diagnosis of neuromuscular disorders of the œsophagus, and is a useful ancillary aid in the differentiation of those disorders from suspected organic obstruction.Of the 65 patients with symptoms, 14 had hiatus hernia, 11 diffuse spasm, seven achalasia, seven scleroderma, four obstructive dysphagia and the remainder normal motility.
TOXOPLASMOSIS: AN EPIDEMIOLOGICAL STUDY
Authors: JENNIS F. 
Published: September 2017

SUMMARYSera received from subjects suspected of toxoplasmosis were examined for hæmagglutinating antibodies and compared with sera from an apparently normal population.In cases of chorio‐retinitis, a significantly higher than normal proportion of positive results was demonstrated in all age groups. The results also suggest that in children and young adults infection with Toxoplasma may be a far from rare cause of disease of the reticulo‐endothelial system.
A CHROMOSOME ABNORMALITY ASSOCIATED WITH MACROGLOBULINÆMIA
Authors: BLAKE M. N. 
Published: September 2017

SUMMARYExamination of serum from an adult male patient with lymphosarcoma showed the presence of two macroglobulins and a large amount of cryoglobulin.Chromosome studies on peripheral blood leucocytes, cultured prior to any treatment, showed that of 110 cells analysed, 21 contained an extra chromosome of abnormal morphology. All the abnormal chromosomes were large; 18 showed a submedian centromere, the remaining three a median centromere.A biometric comparison of the arm lengths of these abnormal chromosomes with the corresponding measurements for the 1–3 and 4–5 groups, and the four longest chromosomes of the X+ (6–12) group, suggests that the abnormal chromosome was not related to the normal number 2 pair, as previously suggested by reports of similar cases.
THE CLINICAL SIGNIFICANCE OF PLASMA THYROID‐STIMULATING ACTIVITY IN HYPERTHYROIDISM
Authors: HOFFMANN M. JOHN , HETZEL BASIL S. 
Published: September 2017

SUMMARYThe long‐acting thyroid stimulator (LATS) measured by the method of McKenzie was detected in 36 of 60 cases of untreated hyperthyroidism—a figure comparable with that in other reported series.An association was found between LATS and several clinical features. There was a definite correlation between LATS and the occurrence of exophthalmos. The mean LATS level of 433% in 13 exophthalmic patients was significantly greater than the mean of 230% in 50 patients without exophthalmos (P<0·02. There was also a significantly higher level of LATS (P<0·05) in 34 patients who had a visible goitre (323%) than in 24 without visible goitre (184%). Sixteen patients who eventually had a recurrence of hyperthyroidism after therapy were found to have a significantly higher mean LATS level (411%) than 34 subjects who remained well (182%) (P<0·01).No correlation could be found between plasma LATS level and (a) thyroid 131I turnover, (b) the plasma level of protein‐bound iodine and (c) the presence of a significant titre of antibodies to thyroglobulin in the patient's blood (Tanned red‐cell titre 1/2500).The association between LATS and pretibial myxœdema was demonstrated by two patients who both had elevated plasma levels of LATS and unequivocal pretibial myxœdema when first examined. Follow‐up studies over the ensuing three years demonstrated resolution of the pretibial myxœdema concurrently with disappearance of LATS from the plasma of one patient, and increasingly severe pretibial myxœdema associated with an increasing plasma level of LATS in the other.It is concluded that there is a significant relation between the plasma LATS level and various clinical features of hyperthyroidism. These data indicate the importance of LATS in relation to the pathogenesis of the disease. Recent chemical studies indicate that LATS belongs to the 7S globulins. These findings indicate that thyrotoxicosis, exophthalmos and pretibial myxœdema may result from disordered immunological mechanisms.
A FAMILY WITH ALPORT'S SYNDROME OF HEREDITARY NEPHRITIS AND DEAFNESS
Authors: WOOD TREVOR J. , KNIGHT L. W. 
Published: September 2017

SUMMARYA family is reported, in which four of the six siblings are affected by a nephropathy and two of these siblings are deaf. This fulfils the criteria for a diagnosis of Alport's syndrome. The renal lesion in this family appears to be indistinguishable from chronic glomerulonephritis, and the clinical manifestation of this nephropathy was as bouts of hæmaturia since childhood. The two affected males were more severely affected than the females, the eldest male having died at the age of 25 years from chronic renal failure. The more unusual manifestations of this syndrome—namely, the ocular and mental changes or the amino aciduria—were not present in this family.
NEONATAL THYROTOXICOSIS: REPORT OF THREE CASES INVOLVING FOUR INFANTS
Authors: HOFFMANN M. J. , HETZEL B. S. , MANSON J. 
Published: September 2017

SUMMARYFour cases of neonatal hyperthyroidism are described. The condition was shown to be transient and associated with thyrotoxicosis in the mothers of the patients.Assays for long‐acting thyroid stimulator (L.A.T.S.) were performed on plasma samples from the neonatal hyperthyroid subjects and their mothers. It was shown that L.A.T.S. was present in all the patients and the mothers, and that it disappeared in the neonate after a few weeks. It is concluded that L.A.T.S. is the pathogenetic agent responsible for the hyperthyroidism by passage across the placenta from the maternal circulation. This finding is consistent with recent chemical evidence that L.A.T.S. is a 7S gamma globulin.
THYROID FUNCTION IN PATIENTS WITH EXOPHTHALMOS PRECEDING THYROTOXICOSIS
Authors: HUDSON BRYAN , BREIDAHL HARALD 
Published: September 2017

SUMMARYEight patients are described who showed the classical ocular manifestations of Graves' disease but none of the other clinical manifestations of hyperthyroidism. In all cases there was an elevated level of PB131I in the plasma after the administration of a tracer dose of 131I, and, in three cases studied, the uptake of 131I by the thyroid was not suppressed by the administration of triiodothyronine. The possible mechanisms are discussed.
ABO BLOOD GROUP, SECRETOR STATUS AND GASTRIC SECRETION
Authors: DENBOROUGH M. A. 
Published: September 2017

SUMMARYThe gastric secretion of acid and pepsin was measured in 93 healthy young male volunteers and related to ABO blood group and secretor status.No evidence for an increased secretion of gastric acid and pepsin in group O individuals or non‐secretors was found. The implications of these findings are discussed.
CHRONIC LUNG DISEASE IN THE TERRITORY OF PAPUA AND NEW GUINEA—AN EPIDEMIOLOGICAL STUDY
Authors: WOOLCOCK ANN J. , BLACKBURN C. R. B. 
Published: September 2017

SummaryA preliminary epidemiological survey of natives in the Eastern and Western Highlands of the Territory of Papua and New Guinea shows that chronic lung disease is common.The disease is more frequently seen in natives aged over 30 years, appears to be restrictive in the early stages but to produce obstruction as well in the later stages, and appears to lead to cor pulmonale. The cause is not known, but repeated infections appear to be an important factor.A definitive epidemiological study is planned to investigate the incidence, nature, cause and course of chronic lung disease and to define its relationship to cor pulmonale. The plan of this study is outlined.
CYTOGENETIC STUDIES IN CHRONIC GRANULOCYTIC LEUKÆMIA
Authors: DOUGAN L. , ONESTI P. , WOODLIFF H. J. 
Published: September 2017

SummaryA review of the literature shows that the Philadelphia (Ph1) chromosome is present in cells from a majority of patients with chronic granulocytic leukæmia, including 19 presented here. An adequate explanation has been found for the failure to demonstrate the Ph1 chromosome in all but four cases in the literature. The Ph1 chromosome has only rarely been reported in other myeloproliferative disorders, and never in other conditions. The positivity in the myeloproliferative disorders is discussed and the probability that the few reported cases are atypical examples of chronic granulocytic leukæmia is considered. The diagnostic value of cytogenetic studies in prognosis and therapy is considered. The conclusion is reached that such studies are of definite but limited value.Theoretical implications of the Ph1 chromosome are discussed with particular reference to the stem cell, leucopoiesis and chromosome 21, the inter‐relationship of the myeloproliferative disorders and the pathogenesis of chronic granulocytic leukæmia.
STUDIES ON DEFICIENCY AND ABSORPTION OF FOLATES IN PATIENTS ON ANTICONVULSANT DRUGS
Authors: IBBOTSON R. N. , DILENA BEVERLEY A. , HORWOOD M. 
Published: September 2017

SummaryThe incidence of macrocytosis and low serum folate levels has been estimated in 115 mental hospital patients on anticonvulsant drug therapy and in 48 mental hospital control patients. Low serum folate levels were found in 36·1% of the patients treated with anticonvulsants.Of the patients on anticonvulsants, 14·6% had red cell macrocytosis, and the incidence of macrocytosis was significantly higher in female than in male patients.The mental hospital patients not on anticonvulsants who were used as controls had mean serum folate values significantly below that of the normal, non‐hospitalized controls. Attention is drawn to the influence of the diet on normal folate ranges, which must be taken into account during their assessment. The fact that a combination of factors is probably necessary to produce a frank megaloblastic change in anticonvulsant‐drug‐treated patients could account for the relative infrequency of megaloblastosis among these patients. It is believed that, in case of anticonvulsant drug therapy, a borderline folate diet often interacts with the mild drug folate inhibition.Folic acid absorption tests, carried out on 19 patients on anticonvulsant therapy with subnormal folate levels, showed slightly decreased absorption values at two hours after the oral test dose but no difference at three hours. The significance of these findings is discussed, and attention is drawn to possible mechanisms of mild malabsorption of folates in patients on anticonvulsant drugs.
ATROPHIC GASTRITIS IN THE AGED
Authors: ANDREWS G. R. , HANEMAN BEN , ARNOLD B. J. , BOOTH J. COOPER , TAYLOR KENNETH 
Published: September 2017

SUMMARYThe incidence of gastritis and the correlation of this finding with the presence of circulating parietal cell antibodies and gastric secretory function was studied in 24 asymptomatic subjects aged over 6o years. A gastric biopsy examination, a maximal histamine‐stimulation test, a test for parietal cell antibody and a Schilling test were performed on each subject. The biopsy specimens were examined by histological and histochemical methods. The gastric juice was assayed for acid and intrinsic factor content, and the serum iron and vitamin B12 levels were measured.All but one subject showed some degree of chronic atrophic gastritis. Close correlation was found between gastric secretory function, the histological changes in the gastric mucosa and the reduction in specialized cells demonstrated on histochemical examination. Two subjects presented a “pre‐pernicious anæmia” picture with gross reduction in intrinsic factor secretion, a degree of malabsorption of vitamin B12 but no evidence of vitamin B12 deficiency; a very similar case not included in the series is described to illustrate the diagnostic problem which may occur with hæmatological evidence of vitamin B12 deficiency as a result of atrophic gastritis. Serum iron levels were reduced in some cases with severe atrophic gastritis. Antibodies to parietal cells occurred with increasing frequency as the changes in the gastric mucosa became more marked.Atrophic gastritis is a common finding in the “normal” aged male even in the absence of gastrointestinal symptoms, and a clinical picture simulating early pernicious anæmia may occur as a result of “normal ageing” of the gastric mucosa.
A STUDY OF CORTISOL METABOLISM IN PATIENTS WITH CHRONIC ASTHMA
Authors: DWYER J. , LAZARUS L. , HICKIE J. B. 
Published: September 2017

SUMMARYThe mortality rate in asthma is rising and, in our hospital, the majority of deaths occur during episodes of status asthmaticus in steroid‐treated patients. Clinical observations have indicated that relatively large doses of cortisol are necessary to treat acute episodes of asthma in the long‐term‐steroid‐treated patient. Studies on 10 patients indicate that the plasma cortisol response to the intravenous injection of cortisol is less than normal in steroid‐treated patients, and that this reduced response is associated with a lack of clinical improvement.A good clinical response in steroid‐treated patients does not occur until the plasma cortisol level is at least 100 µg. per 100 ml. Studies of cortisol metabolism in the case of these 10 patients demonstrate an increased rate of removal of cortisol. The metabolic clearance rate of cortisol is higher than in normal subjects and in non‐steroid‐treated asthmatic patients. The metabolic clearance rate of cortisol is not affected by the administration of ACTH, but is reduced in steroid‐treated patients who are simultaneously receiving æstrogen therapy. These studies indicate the need to administer an initial relatively large dose of cortisol to steroid‐treated asthmatic patients in status asthmaticus.
THE ABO SYSTEM IN MILK AND SALIVA
Authors: DENBOROUGH M. A. , DOWNING H. J. , MCCREA MARY G. 
Published: September 2017

SUMMARYIn a study of the ABO system in milk and saliva, the following observations were made:Isoagglutinins were found in 91·6% of milk samples and in 62·7% of saliva specimens.Anti‐B isoagglutinins were present in greater amounts in group O individuals than in group A, both in milk and in saliva.Blood group substance A specificity was poorly expressed in milk, and B specificity was virtually not expressed at all.Less H substance was found in milk than in saliva in group O individuals, but more H substance was found in group A and B individuals in milk than in saliva.The possible physiological, clinical and genetic significance of these observations is discussed.
HYPOFIBRINOGENÆMIA IN ACUTE LEUKÆMIA WITH EXTENSIVE FIBRINOUS PERICARDITIS
Authors: HIRSH J. , EKERT H. , TAFT L. I. , COLEBATCH J. H. , SPENSLEY J. C. 
Published: September 2017

SUMMARYA case of acute myeloid leukæmia and hypofibrinogenæmia is described. The hypofibrinogenæmia was associated with decreased levels of factor V and factor VIII, but there was no increase in fibrinolytic activity. The clinical course was marked by a severe hæmorrhagic diathesis and evidence of cardiac tamponade. At autopsy there was extensive fibrinous pericarditis. It is suggested that the extensive pericardial fibrin deposition might have contributed to the coagulation abnormality observed.
DISACCHARIDASE DEFICIENCY IN REGIONAL ENTERITIS
Authors: FIDDES P. J. , BAUME PETER 
Published: September 2017

SUMMARYA man aged 32 years was found to have lactase deficiency in histologically normal jejunal and ileal mucosa, together with regional enteritis affecting the terminal ileum. The diseased ileum exhibited deficiencies of lactase, sucrase and maltase, and there was mucosal destruction. The remainder of the small intestine exhibited isolated lactase deficiency, a diffuse small intestinal defect the relationship of which to regional enteritis is uncertain.
CLINICAL, PHYSIOLOGICAL AND PATHOLOGICAL OBSERVATIONS IN A CASE OF PROGRESSIVE AUTONOMIC NERVOUS SYSTEM DEGENERATION ASSOCIATED WITH HOLMES‐ADIE SYNDROME AND PERIPHERAL NEUROPATHY
Authors: FREWIN D. B. , GILMORE H. R. , HO J. Q. K. , SCROOP G. C. 
Published: September 2017

SummaryThe case history is reported of a woman aged 40 years who presented with weight loss, postural hypotension and paræsthesia in the hands and feet. The diagnosis of widespread autonomic nervous system degeneration with associated peripheral neuropathy and Holmes‐Adie syndrome was made from the results of a series of clinical and physiological tests.Laboratory investigation failed to disclose a cause for the degenerative changes, and symptomatic treatment with 9‐alpha fluorohydrocortisone and digitalis was commenced in an effort to combat the patient's postural hypotension. On this régime there was transient improvement in her clinical state, but over a period of six months her general condition gradually deteriorated and she eventually died.At autopsy, widespread amyloid infiltration of the sympathetic ganglia, peripheral nerves, heart and alimentary canal was found, and this appears to have been the pathological basis for the clinical and physiological findings.